| Doctor Name: | KIMBERLY BAUMAN |
| NPI Number: | 1114330248 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 17107 |
| Business Practice Address: | 1900 Silver Lake Rd Nw New Brighton, MN - 551121786 |
| Business Phone Number: | 6516289566 |
| Business Fax Number: | |
| Mailing Address: | 2016 119th Ave Ne, BLAINE |
| State: | MN |
| Postal Code: | 554496053 |
| Phone Number: | 6514855428 |
| Fax Number: | |
| NPI Enumeration Date: | 06/05/2014 |
| NPI Last Update Date: | 06/05/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 17107 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |