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Jax Taylor Baker, LPC
Professional Counselor in Plymouth, Minnesota
NPI 1790003846

Jax Taylor Baker is a Professional Counselor based in Plymouth, MN and is specialized in Professional. Jax Taylor Baker practices in Plymouth, MN and has the professional credentials of LPC. The NPI Number for Jax Taylor Baker is 1790003846 and holds a License No. 3824 (Minnesota).

The current practice location address for Jax Taylor Baker is 5007 Harbor Lane North, Plymouth, MN and can be reached out via phone at 612-924-3807.

Location: 5007 Harbor Lane North, Plymouth, MN, 55447-5142
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1790003846
Provider Name
Jax Taylor Baker
Credential
LPC
Provider Entity Type
Individual
Gender
Male
Address
5007 Harbor Lane North, Plymouth, MN, 55447-5142
Phone Number
612-924-3807
Fax Number
Provider Enumeration Date
05/13/2010
Last Update Date
08/17/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
228551719 05 AR
institution
Provider Business Practice Location Address Details
Address
5007 Harbor Lane North
City
Plymouth
State
Minnesota
Zip
55447
Phone Number
612-924-3807
Fax Number
person
Provider Business Mailing Address Details
Address
5007 Harbor Lane North
City
Plymouth
State
Minnesota
Zip
55447
Phone Number
612-924-3807
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
101YP2500X
License No.
3824 (Minnesota)
Definition
Definition to come...
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