Provider Demographics
NPI:1093166084
Name:BAEKEY, DIANA
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:
Last Name:BAEKEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 PERIMETER CTR E STE 350
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30346-2204
Mailing Address - Country:US
Mailing Address - Phone:866-750-5554
Mailing Address - Fax:678-809-2530
Practice Address - Street 1:53 PERIMETER CTR E STE 350
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30346-2204
Practice Address - Country:US
Practice Address - Phone:866-750-5554
Practice Address - Fax:678-809-2530
Is Sole Proprietor?:No
Enumeration Date:2016-06-30
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst