Individual
MS. MINDY LYNN BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
898 ABIGAIL CT, AMMON, ID 83406-3500
(208) 206-7840
Mailing address
898 ABIGAIL CT, AMMON, ID 83406-3500
(208) 206-7840
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106S00000X
—
ID
Enumeration date
06/01/2022
Last updated
06/01/2022
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