Provider Demographics
NPI:1487116075
Name:BAER, KAITLYN DANIELLE
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:DANIELLE
Last Name:BAER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1013
Mailing Address - Street 2:
Mailing Address - City:CRESTONE
Mailing Address - State:CO
Mailing Address - Zip Code:81131-1013
Mailing Address - Country:US
Mailing Address - Phone:814-233-4581
Mailing Address - Fax:
Practice Address - Street 1:2300 S GILPIN ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5131
Practice Address - Country:US
Practice Address - Phone:814-233-4581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-02
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health