Provider Demographics
NPI:1740335835
Name:BAKER-SQUIER, TINA RAE (BS, MA)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:RAE
Last Name:BAKER-SQUIER
Suffix:
Gender:F
Credentials:BS, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:352 ENGLISH SPARROW DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-5645
Mailing Address - Country:US
Mailing Address - Phone:303-432-5432
Mailing Address - Fax:
Practice Address - Street 1:10295 W KEENE AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80235-1104
Practice Address - Country:US
Practice Address - Phone:303-980-4082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health