Provider Demographics
NPI:1326221912
Name:BAKER, AMANDA BECHTOLD (MED)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:BECHTOLD
Last Name:BAKER
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SHAPIRO EDUCATIONAL AND BEHAVIORAL CONSULTANTS
Mailing Address - Street 2:39 MAIN STREET
Mailing Address - City:LUNENBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01462
Mailing Address - Country:US
Mailing Address - Phone:978-602-4957
Mailing Address - Fax:
Practice Address - Street 1:SHAPIRO EDUCATIONAL AND BEHAVIORAL CONSULTANTS
Practice Address - Street 2:39 MAIN STREET
Practice Address - City:LUNENBURG
Practice Address - State:MA
Practice Address - Zip Code:01462
Practice Address - Country:US
Practice Address - Phone:978-602-4957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-06
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA371584222Q00000X
MA1-14-16239103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist