Doctor Name: | PERRY BAUER |
NPI Number: | 1326404286 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M. DIV., CDCS |
License Number: | 4117 |
Business Practice Address: | 301 Railway Ave Seward, AK - 996643801 |
Business Phone Number: | 9072245257 |
Business Fax Number: | 9072247081 |
Mailing Address: | Po Box 1045, SEWARD |
State: | AK |
Postal Code: | 996641045 |
Phone Number: | 9072245257 |
Fax Number: | 9072247081 |
NPI Enumeration Date: | 01/07/2016 |
NPI Last Update Date: | 01/07/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 4117 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AK |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |