Doctor Name: | MR. KENNETH B. BAUER |
NPI Number: | 1306913330 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MSW |
License Number: | 44SC00166200 |
Business Practice Address: | 1111 Arnold Ave Point Pleasant Boro, NJ - 087422312 |
Business Phone Number: | 7328990429 |
Business Fax Number: | |
Mailing Address: | 1516 Treeneedle Rd, POINT PLEASANT BORO |
State: | NJ |
Postal Code: | 087423451 |
Phone Number: | 7328993092 |
Fax Number: | |
NPI Enumeration Date: | 11/28/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 44SC00166200 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |