Individual
BRIAN BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5200 COPPER AVE NE, ALBUQUERQUE, NM 87108-1473
(505) 249-1795
Mailing address
PO BOX 4893, ALBUQUERQUE, NM 87196-4893
(505) 249-1795
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
370069
NM
Other
Enumeration date
09/18/2015
Last updated
09/18/2015
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