Provider Demographics
NPI:1477671626
Name:BAKER, RITA M (PHD)
Entity Type:Individual
Prefix:DR
First Name:RITA
Middle Name:M
Last Name:BAKER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 616
Mailing Address - Street 2:
Mailing Address - City:MORRISON
Mailing Address - State:CO
Mailing Address - Zip Code:80465-0616
Mailing Address - Country:US
Mailing Address - Phone:303-973-7300
Mailing Address - Fax:
Practice Address - Street 1:9200 W CROSS DR
Practice Address - Street 2:SUITE 405
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80123-2239
Practice Address - Country:US
Practice Address - Phone:303-973-7300
Practice Address - Fax:303-697-6333
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1165103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist