Provider Demographics
NPI:1700547833
Name:BAIZE, SHAUNTA
Entity Type:Individual
Prefix:
First Name:SHAUNTA
Middle Name:
Last Name:BAIZE
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:SHAUNTA
Other - Middle Name:
Other - Last Name:SKINNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:206 NICEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23602-6526
Mailing Address - Country:US
Mailing Address - Phone:757-570-3546
Mailing Address - Fax:
Practice Address - Street 1:206 NICEWOOD DR
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23602-6526
Practice Address - Country:US
Practice Address - Phone:757-570-3546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-30
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor