Provider Information for 1811508112
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Mrs. JOANNE BAKER DEAL LPC
Sex: Female
NPI: 1811508112
Last Updated: 2020-08-11
Certification Date: 2020-08-11
Certification Date: 2020-08-11
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1811508112 | ||||||||
| Enumeration Date | 2020-08-11 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 68 MARES HILL RD IVORYTON, CT 06442-1257 United States Phone: 860-304-5695 | Fax: | ||||||||
| Primary Practice Address | 68 MARES HILL RD IVORYTON, CT 06442-1257 United States Phone: 860-304-5695 | Fax: | ||||||||
| Secondary Practice Address(es) | 1185 DURHAM RD 17 WATER ST STE 2 | ||||||||
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