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NPI Code Detail

MEDICARE: TINA RAE BAKER-SQUIER BS, MA

MEDICARE: TINA RAE BAKER-SQUIER BS, MA
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 : 1740335835
Entity Type Code : Individual
Provider Name (Legal Business Name) : TINA RAE BAKER-SQUIER BS, MA
Provider Business Mailing Address
First Line : 352 ENGLISH SPARROW DR
Second Line :
City : HIGHLANDS RANCH
State : CO
Zip : 80129-5645
Country : US
Telephone Number : 303-432-5432
Fax Number :
Provider Business Practice Location Address
First Line : 10295 W KEENE AVE
Second Line :
City : LAKEWOOD
State : CO
Zip : 80235-1104
Country : US
Telephone Number : 303-980-4082
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2007
Last Update Date : 07/08/2007

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