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NPI Code Detail

MEDICARE: TANYA BAKER LCSW

MEDICARE: TANYA BAKER LCSW
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
11041C0700XClinical Social WorkerX-10620NM
21041C0700XClinical Social WorkerC-11440NM

General Provider Information

NPI Number : 1437635927
Entity Type Code : Individual
Provider Name (Legal Business Name) : TANYA BAKER LCSW
Provider Business Mailing Address
First Line : 3939 SAN PEDRO DR NE BLDG B1
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87110-8903
Country : US
Telephone Number : 505-903-5437
Fax Number :
Provider Business Practice Location Address
First Line : 3939 SAN PEDRO DR NE BLDG B1
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87110-8903
Country : US
Telephone Number : 505-903-5437
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2018
Last Update Date : 04/01/2021

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Directions to “ TANYA BAKER LCSW” Practice Location

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