Healthcare Provider Details

I. General information

NPI: 1588575864
Provider Name (Legal Business Name): ANGELA MARIE BAKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1980 DOMINION WAY STE 202
COLORADO SPRINGS CO
80918-8473
US

IV. Provider business mailing address

7853 STEWARD LN
COLORADO SPRINGS CO
80922-6317
US

V. Phone/Fax

Practice location:
  • Phone: 719-210-7685
  • Fax:
Mailing address:
  • Phone: 719-210-7685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: