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General NPI Number Information
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NPI Number | 1225691330
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Entity Type | Individual
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Provider Name | DENISE ANN MCDUFFEY-BAUER
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Gender | Male
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Dates
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Enumeration Date | 04/16/2019
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Last Update Date | 08/20/2021
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Provider Practice Location Address
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Address Line | 805 CENTRAL AVE STE 300
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City | FORT DODGE
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State | IA
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Zip | 50501-3954
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Country | US
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Telephone | 806-570-4882
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Fax |
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Provider Business Mailing Address
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Address Line | 2525 16TH AVE N
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City | FORT DODGE
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State | IA
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Zip | 50501-7906
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Country | US
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Telephone | 806-570-4882
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW18571
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 110051
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License Number State | IA
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