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General NPI Number Information
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NPI Number | 1215899919
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Entity Type | Individual
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Provider Name | ANGIE MYRTLENE BAKER ED.D.
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Gender | Female
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 2203 ALASKA AVE
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City | DALLAS
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State | TX
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Zip | 75216-2305
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Country | US
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Telephone | 214-537-8133
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Fax |
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Provider Business Mailing Address
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Address Line | 235 TREES DR
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City | CEDAR HILL
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State | TX
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Zip | 75104-1200
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Country | US
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Telephone | 214-537-8133
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 74061
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 74061
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License Number State | TX
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