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NPI Code Detail

MEDICARE: MAKENSIE BAKER

MEDICARE: MAKENSIE 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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1528304821
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAKENSIE BAKER
Provider Business Mailing Address
First Line : 160 E 100 N
Second Line : #7
City : BOUNTIFUL
State : UT
Zip : 84010-4849
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 724 E 2100 S
Second Line : SUITE B
City : SALT LAKE CITY
State : UT
Zip : 84106-1830
Country : US
Telephone Number : 801-487-0499
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2012
Last Update Date : 12/14/2012

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Directions to “ MAKENSIE BAKER ” Practice Location

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