Provider Demographics
NPI:1275782138
Name:BAKER, TAMARA LEIGH (PHD)
Entity Type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:LEIGH
Last Name:BAKER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7 STODDARD CT
Mailing Address - Street 2:
Mailing Address - City:SPARKS GLENCOE
Mailing Address - State:MD
Mailing Address - Zip Code:21152-9367
Mailing Address - Country:US
Mailing Address - Phone:301-471-3557
Mailing Address - Fax:
Practice Address - Street 1:7067 COLUMBIA GATEWAY DR STE 180
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-3408
Practice Address - Country:US
Practice Address - Phone:410-929-7225
Practice Address - Fax:443-333-5434
Is Sole Proprietor?:No
Enumeration Date:2008-09-16
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03175103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0381926 00Medicaid
MDC9RQTLOtherCAREFIRST BCBS
MD99550316OtherAETNA
MD600697029OtherMAGELLAN
MD128463OtherMEDICARE PTAN
MD3293755OtherCIGNA
MD203301OtherVALUEOPTIONS