Basic Information
| Provider Information | |||||||||
| NPI: | 1861753527 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BAKER | ||||||||
| FirstName: | ALLISON | ||||||||
| MiddleName: | JANE | ||||||||
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| Credential: | MS, LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1912 GREEN ST | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191303207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9083910729 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1822 SPRING GARDEN ST | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191304122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2155640680 | ||||||||
| FaxNumber: | 2155640732 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/30/2012 | ||||||||
| LastUpdateDate: | 05/30/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | PC006257 | PA | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.