Provider Demographics
NPI:1861834632
Name:BAKER, LAURA A (MED)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:A
Last Name:BAKER
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1811 BETHLEHEM PIKE
Mailing Address - Street 2:BDG B-1 SUITE 211
Mailing Address - City:FLOURTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19031-1111
Mailing Address - Country:US
Mailing Address - Phone:215-836-1383
Mailing Address - Fax:215-836-1384
Practice Address - Street 1:1811 BETHLEHEM PIKE
Practice Address - Street 2:BDG B-1 SUITE 211
Practice Address - City:FLOURTOWN
Practice Address - State:PA
Practice Address - Zip Code:19031-1111
Practice Address - Country:US
Practice Address - Phone:215-836-1383
Practice Address - Fax:215-836-1384
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-22
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst