Healthcare Provider Details

I. General information

NPI: 1164686598
Provider Name (Legal Business Name): AARON W BAUMGARTNER PCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2008
Last Update Date: 07/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 N LOCUST ST
OTTAWA OH
45875-1216
US

IV. Provider business mailing address

835 N LOCUST ST
OTTAWA OH
45875-1216
US

V. Phone/Fax

Practice location:
  • Phone: 419-523-4300
  • Fax: 419-523-6188
Mailing address:
  • Phone: 419-523-4300
  • Fax: 419-523-6188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0003585
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: