Provider Demographics
NPI:1649751348
Name:BAKER, AMY MARIE (MSW)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:MARIE
Last Name:BAKER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 BAY RD
Mailing Address - Street 2:
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804-3012
Mailing Address - Country:US
Mailing Address - Phone:518-952-9032
Mailing Address - Fax:518-252-6445
Practice Address - Street 1:375 BAY RD
Practice Address - Street 2:
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804-3012
Practice Address - Country:US
Practice Address - Phone:518-952-9032
Practice Address - Fax:518-252-6445
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-22
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP108751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical