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General NPI Number Information
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NPI Number | 1356581102
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Entity Type | Organization
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Legal Business Name | CHRIS BAUER PH.D. LLC
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Dates
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Enumeration Date | 03/05/2009
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Last Update Date | 03/05/2009
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Provider Practice Location Address
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Address Line | 2000 FOUNDATION WAY SUITE 3500
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City | MARTINSBURG
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State | WV
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Zip | 25401-9003
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Country | US
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Telephone | 703-507-0680
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Fax |
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Provider Business Mailing Address
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Address Line | 2000 FOUNDATION WAY SUITE 3500
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City | MARTINSBURG
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State | WV
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Zip | 25401-9003
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Country | US
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Telephone | 703-507-0680
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. CHRIS M BAUER
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Credential | PH.D.
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Telephone | 703-507-0680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 955
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License Number State | WV
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