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NPI Code Detail

MEDICARE: RENEE L BAKER

MEDICARE: RENEE L 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
11041C0700XClinical Social Worker49CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12975932OTHERCOCIGNA BEHAVIORAL HEALTH

General Provider Information

NPI Number : 1962759746
Entity Type Code : Individual
Provider Name (Legal Business Name) : RENEE L BAKER
Provider Business Mailing Address
First Line : 305 CARPENTER RD
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525-4248
Country : US
Telephone Number : 970-663-3500
Fax Number : 970-292-1085
Provider Business Practice Location Address
First Line : 305 CARPENTER RD
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525-4248
Country : US
Telephone Number : 970-663-3500
Fax Number : 970-292-1085
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2012
Last Update Date : 08/10/2012

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Directions to “ RENEE L BAKER ” Practice Location

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