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General NPI Number Information
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NPI Number | 1487541066
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Entity Type | Individual
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Provider Name | DEIDRE BAKER LMT
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Gender | Female
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Dates
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Enumeration Date | 06/18/2025
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 4100 S LINDSAY RD STE 111
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City | GILBERT
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State | AZ
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Zip | 85297-1507
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Country | US
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Telephone | 720-773-2070
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Fax |
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Provider Business Mailing Address
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Address Line | 1925 S CORONADO RD APT 2078
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City | GILBERT
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State | AZ
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Zip | 85295-2216
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Country | US
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Telephone | 303-981-3222
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT-21000
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License Number State | AZ
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