Provider Demographics
NPI:1902317894
Name:BAKER, MARYANNE (CPCP)
Entity Type:Individual
Prefix:
First Name:MARYANNE
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:CPCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42713 N 14TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW RIVER
Mailing Address - State:AZ
Mailing Address - Zip Code:85087-0919
Mailing Address - Country:US
Mailing Address - Phone:623-810-7557
Mailing Address - Fax:
Practice Address - Street 1:8711 E PINNACLE PEAK RD STE F-113
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-3517
Practice Address - Country:US
Practice Address - Phone:623-810-8558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-18
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZA2600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherArt, Medical