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General NPI Number Information
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NPI Number | 1316713902
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Entity Type | Individual
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Provider Name | MOLLY E BAUER BCBA
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Gender | Female
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Dates
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Enumeration Date | 11/27/2023
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 280 CROSSWAYS PARK DR
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City | WOODBURY
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State | NY
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Zip | 11797-2015
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Country | US
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Telephone | 516-938-1784
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Fax |
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Provider Business Mailing Address
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Address Line | 3019 NEWPORT AVE
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City | MEDFORD
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State | NY
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Zip | 11763-1847
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Country | US
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Telephone | 516-780-1493
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 003202-01
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License Number State | NY
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