Provider Demographics
NPI:1801199476
Name:BAKER, KRISTI GENOVESE (PHD)
Entity Type:Individual
Prefix:DR
First Name:KRISTI
Middle Name:GENOVESE
Last Name:BAKER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:KRISTINE
Other - Middle Name:ANN
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6300 HARRY HINES BLVD STE 1200
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-5239
Mailing Address - Country:US
Mailing Address - Phone:214-456-5932
Mailing Address - Fax:214-456-4273
Practice Address - Street 1:6300 HARRY HINES BLVD STE 1200
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-5239
Practice Address - Country:US
Practice Address - Phone:214-456-5932
Practice Address - Fax:214-456-4273
Is Sole Proprietor?:No
Enumeration Date:2010-12-21
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34763103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical