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General NPI Number Information
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NPI Number | 1912581919
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Entity Type | Individual
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Provider Name | THERESA ANTIMA BAUER MS, LMFT
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Gender | Female
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Dates
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Enumeration Date | 05/06/2021
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 261 CHAPMAN RD
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City | NEWARK
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State | DE
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Zip | 19702-5423
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Country | US
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Telephone | 302-455-9333
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Fax |
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Provider Business Mailing Address
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Address Line | 4853 PLUM RUN CT
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City | WILMINGTON
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State | DE
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Zip | 19808-1715
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Country | US
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Telephone | 941-626-7805
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MT4857
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | FT0010163
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License Number State | DE
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