Healthcare Provider Details

I. General information

NPI: 1801862990
Provider Name (Legal Business Name): ROBERT W. BAER PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 10/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 2ND AVE E SUITE B
DICKINSON ND
58601-5218
US

IV. Provider business mailing address

11 2ND AVE E SUITE B
DICKINSON ND
58601-5218
US

V. Phone/Fax

Practice location:
  • Phone: 701-483-9720
  • Fax: 701-483-9721
Mailing address:
  • Phone: 701-483-9720
  • Fax: 701-483-9721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number386
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: