Provider Demographics
NPI:1730905357
Name:BAKER, MELISSA ANGELA (MS)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANGELA
Last Name:BAKER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:ANGELA
Other - Last Name:KREITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4747 N 7TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-3654
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5701 W TALAVI BLVD STE 180
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-1888
Practice Address - Country:US
Practice Address - Phone:602-828-0448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-27
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist