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NPI Code Detail

MEDICARE: TIFFANY JYNETTE BAKER

MEDICARE: TIFFANY JYNETTE 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 TechnicianMI

General Provider Information

NPI Number : 1306797618
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIFFANY JYNETTE BAKER
Provider Business Mailing Address
First Line : 13976 FAUST AVE
Second Line :
City : DETROIT
State : MI
Zip : 48223-3540
Country : US
Telephone Number : 313-828-1101
Fax Number :
Provider Business Practice Location Address
First Line : 18917 JOY RD
Second Line :
City : DETROIT
State : MI
Zip : 48228-3050
Country : US
Telephone Number : 248-289-3008
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2026
Last Update Date : 02/04/2026

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Directions to “ TIFFANY JYNETTE BAKER ” Practice Location

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