Provider Demographics
NPI:1134624679
Name:BAKER-BROWN, SHUNTARA R
Entity type:Individual
Prefix:MRS
First Name:SHUNTARA
Middle Name:R
Last Name:BAKER-BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 CONGRESS ST BLDG 21
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-5529
Mailing Address - Country:US
Mailing Address - Phone:978-745-2440
Mailing Address - Fax:978-744-1701
Practice Address - Street 1:35 CONGRESS ST STE 2
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-5567
Practice Address - Country:US
Practice Address - Phone:978-745-2440
Practice Address - Fax:978-744-1701
Is Sole Proprietor?:No
Enumeration Date:2018-03-27
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health