MISS Makenzie Baker X, BS

NPI #1780053348 in Fairfield, Illinois

Provider Information

NPI Number: 1780053348
Entity Type: Individual
Name: MISS Makenzie Baker X, BS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Addiction (Substance Use Disorder)
Credential: BS
Enumeration Date: Sep 24, 2015
Last Updated: Sep 24, 2015

Practice Location

Address: 407 N BASIN RD
City: Fairfield
State: Illinois
ZIP Code: 62837-9639
Phone: (618) 842-2125

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X	Primary
Counselor - Mental Health — Mental Health	101YM0800X
Counselor - Professional — Professional	101YP2500X

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Organizations

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