Doctor Name: | MS. CORRINE ARLENE BAUER |
NPI Number: | 1235205899 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A., L.P. |
License Number: | LP1462 |
Business Practice Address: | 3570 Lexington Ave N 100 Shoreview, MN - 551268049 |
Business Phone Number: | 6514810664 |
Business Fax Number: | 6514813907 |
Mailing Address: | 2662 South Ave E, SAINT PAUL |
State: | MN |
Postal Code: | 551093311 |
Phone Number: | 6517733513 |
Fax Number: | |
NPI Enumeration Date: | 11/27/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC1900X |
License Number: | LP1462 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Counseling |
Taxonomy Definition: |