Provider Demographics
NPI:1124403902
Name:DOREE BAKER-NEWBERY
Entity Type:Organization
Organization Name:DOREE BAKER-NEWBERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DOREE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BAKER-NEWBERY
Authorized Official - Suffix:
Authorized Official - Credentials:MS,MAC,CACIII,SEP
Authorized Official - Phone:303-443-7695
Mailing Address - Street 1:6901 LOOKOUT RD
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-3529
Mailing Address - Country:US
Mailing Address - Phone:303-443-7695
Mailing Address - Fax:303-530-0807
Practice Address - Street 1:6901 LOOKOUT RD
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-3529
Practice Address - Country:US
Practice Address - Phone:303-443-7695
Practice Address - Fax:303-530-0807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-22
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACC 1040251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management