Basic Information
| Provider Information | |||||||||
| NPI: | 1740335835 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BAKER-SQUIER | ||||||||
| FirstName: | TINA | ||||||||
| MiddleName: | RAE | ||||||||
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| Credential: | BS, MA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 352 ENGLISH SPARROW DR | ||||||||
| Address2: | |||||||||
| City: | HIGHLANDS RANCH | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801295645 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034325432 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10295 W KEENE AVE | ||||||||
| Address2: | |||||||||
| City: | LAKEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802351104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3039804082 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/25/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.