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General NPI Number Information
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NPI Number | 1922140433
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Entity Type | Individual
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Provider Name | MR. BRIAN JOSEPH BAUDUIN
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Gender | Male
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 12/31/2013
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Provider Practice Location Address
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Address Line | 6889 S EASTERN AVE
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City | LAS VEGAS
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State | NV
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Zip | 89119-4687
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Country | US
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Telephone | 702-434-1200
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Fax |
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Provider Business Mailing Address
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Address Line | 1890 MORGANTON DR
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City | HENDERSON
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State | NV
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Zip | 89052-6957
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Country | US
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Telephone | 704-996-3327
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 1655
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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