MEDICARE: EMILY BAKER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1336708718
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY BAKER

Provider Business Mailing Address
First Line	:	21505 N 78TH AVE
Second Line	:	SUITE 125
City	:	PEORIA
State	:	AZ
Zip	:	85382-3356
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5974 FASHION POINT DR STE 210
Second Line	:
City	:	SOUTH OGDEN
State	:	UT
Zip	:	84403-4842
Country	:	US
Telephone Number	:	801-683-1062
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2019
Last Update Date	:	12/23/2025

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Directions to “ EMILY BAKER ” Practice Location

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