MEDICARE: AMANDA R 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	106H00000X	Marriage & Family Therapist	MFTC.0014699	CO

General Provider Information

NPI Number	:	1063052942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA R BAKER

Provider Business Mailing Address
First Line	:	2850 MCCLELLAND DR STE 2000
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-2581
Country	:	US
Telephone Number	:	970-414-0016
Fax Number	:

Provider Business Practice Location Address
First Line	:	375 E HORSETOOTH RD BLDG 4201
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-3198
Country	:	US
Telephone Number	:	970-999-0440
Fax Number	:

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

Provider Enumeration Date	:	01/08/2020
Last Update Date	:	02/11/2026

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Directions to “ AMANDA R BAKER ” Practice Location

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