Kimberly Ann Baker

Individual provider Active NPI Behavior Technician · Midwest City, OK

NPI 1669011268 · NPPES record last updated Nov 11, 2022

Key facts

NPI
1669011268
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
RBT-22-215981 (UT)
Practice address
1212 S Air Depot Blvd Ste 9
Midwest City, OK 73110-4860
Phone
(405) 455-6868
Fax
(405) 562-3444
NPI assigned
Dec 30, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RBT-22-215981UTMDBehavior Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-22-215981 UT Yes

Addresses

Primary practice location

1212 S Air Depot Blvd Ste 9
Midwest City, OK 73110-4860

Mailing address

1212 S Air Depot Blvd Ste 9
Midwest City, OK 73110-4860
Phone (405) 455-6868

Other providers in Midwest City, OK

All providers in Midwest City, OK · Behavior Technician in Oklahoma

Sources for this page

Verify at the official NPI Registry.