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Contact Information

BRAD BAKER, PHD
2235 E 25TH ST STE 290
IDAHO FALLS, ID83404-7595
 Phone: 208-552-0490
 Fax: 208-552-2518
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Professional

101YP2500X
Indicates primary specialty

NPI Profile & details for BRAD BAKER · (Male)

NPI # 1245391549
Status Active
Credentials PHD
Entity Individual
Enumeration date 12/12/2006
Last updated 07/09/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • ID License # LCPC-3192
  • ID Medicaid 806472900
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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