Provider Demographics
NPI:1992031868
Name:BAKER, KOREEN (MSW)
Entity Type:Individual
Prefix:MRS
First Name:KOREEN
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 S SEMORAN BLVD STE 2-1047
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-5526
Mailing Address - Country:US
Mailing Address - Phone:321-203-2213
Mailing Address - Fax:
Practice Address - Street 1:1035 S SEMORAN BLVD STE 2-1047
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792
Practice Address - Country:US
Practice Address - Phone:321-203-2213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-27
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker