MEDICARE: SARA BAAK

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	103K00000X	Behavior Analyst	1-20-42540	CO

General Provider Information

NPI Number	:	1699140566
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA BAAK

Provider Business Mailing Address
First Line	:	9959 VICTOR ST
Second Line	:
City	:	COMMERCE CITY
State	:	CO
Zip	:	80022-9628
Country	:	US
Telephone Number	:	314-629-8831
Fax Number	:

Provider Business Practice Location Address
First Line	:	13659 E 104TH AVE UNIT 100
Second Line	:
City	:	COMMERCE CITY
State	:	CO
Zip	:	80022-9402
Country	:	US
Telephone Number	:	314-629-8831
Fax Number	:

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

Provider Enumeration Date	:	12/03/2015
Last Update Date	:	08/02/2024

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Directions to “ SARA BAAK ” Practice Location

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