Provider Demographics
NPI:1568271815
Name:BAKER-STRAYER, DOMINI (RN, LMSW)
Entity type:Individual
Prefix:MS
First Name:DOMINI
Middle Name:
Last Name:BAKER-STRAYER
Suffix:
Gender:F
Credentials:RN, LMSW
Other - Prefix:
Other - First Name:DOMINI
Other - Middle Name:
Other - Last Name:BAKER-STRAYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DOMINI BAKER
Mailing Address - Street 1:5377 N FERRARA AVE
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83646-2920
Mailing Address - Country:US
Mailing Address - Phone:208-841-3716
Mailing Address - Fax:
Practice Address - Street 1:10096 W FAIRVIEW AVE STE 160
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-5004
Practice Address - Country:US
Practice Address - Phone:208-908-7882
Practice Address - Fax:208-908-7883
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-02
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty