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General NPI Number Information
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NPI Number | 1083060842
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Entity Type | Individual
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Provider Name | DANIELLE BAUER R.D.
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Gender | Female
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Dates
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Enumeration Date | 05/11/2016
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Last Update Date | 06/06/2016
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Provider Practice Location Address
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Address Line | 776 E COLUMBIA ST
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City | MASON
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State | MI
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Zip | 48854-1345
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Country | US
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Telephone | 517-883-5028
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Fax | 517-883-5028
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Provider Business Mailing Address
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Address Line | 776 E COLUMBIA ST
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City | MASON
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State | MI
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Zip | 48854-1345
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Country | US
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Telephone | 517-883-5028
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Fax | 517-883-5028
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 929865
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License Number State | MI
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