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NPI Code Detail

MEDICARE: BETHANY BAKER

MEDICARE: BETHANY 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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1194187500
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETHANY BAKER
Provider Business Mailing Address
First Line : 2985 N 935 E
Second Line : SUITE 7
City : LAYTON
State : UT
Zip : 84040-7318
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2985 N 935 E
Second Line : SUITE 7
City : LAYTON
State : UT
Zip : 84040-7318
Country : US
Telephone Number : 801-771-0273
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2016
Last Update Date : 01/31/2017

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Directions to “ BETHANY BAKER ” Practice Location

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