Baker, Brad
Baker, Brad is an individual health care provider with primary practice located at 2235 E 25Th St Ste 290 , Idaho Falls ID 83404-7595. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Baker, Brad can be contacted via phone (208) 552-0490.Contact Information
Primary practice address
2235 E 25Th St Ste 290
Idaho Falls ID 83404-7595
Phone: (208) 552-0490
Fax: (208) 552-2518
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | LCPC-3192 | Idaho |
Profile Details
| NPI number | 1245391549 |
|---|---|
| LBN Legal business name | Baker, Brad |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 12th, 2006 |
| Last updated | Jul 9th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245391549 | NPPES |
| Idaho | MEDICAID | 806472900 |
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