MEDICARE: AARON BAKER PHD

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	101YM0800X	Mental Health Counselor	076371	IA
2	103TC0700X	Clinical Psychologist	101471	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104214154
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AARON BAKER PHD

Provider Business Mailing Address
First Line	:	1106 4TH ST STE 205
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51101-1958
Country	:	US
Telephone Number	:	712-252-1473
Fax Number	:

Provider Business Practice Location Address
First Line	:	1106 4TH ST STE 205
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51101-1958
Country	:	US
Telephone Number	:	712-252-1473
Fax Number	:

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

Provider Enumeration Date	:	12/29/2014
Last Update Date	:	05/18/2021

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Directions to “ AARON BAKER PHD” Practice Location

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