Provider Demographics
NPI:1699097071
Name:BAKER, KIRK
Entity type:Individual
Prefix:MR
First Name:KIRK
Middle Name:
Last Name:BAKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7099 N HUALAPAI WAY
Mailing Address - Street 2:#1135
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89166-1102
Mailing Address - Country:US
Mailing Address - Phone:702-525-4505
Mailing Address - Fax:
Practice Address - Street 1:7099 N HUALAPAI WAY
Practice Address - Street 2:#1135
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89166-1102
Practice Address - Country:US
Practice Address - Phone:702-525-4505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-25
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor