Individual
KELLY BAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
11200 WAPLES MILL RD, SUITE 180, FAIRFAX, VA 22030-7407
(703) 383-8333
(703) 383-3183
Mailing address
2099 N COLLINS BLVD, SUITE 100, RICHARDSON, TX 75080-2698
(972) 437-4698
(972) 671-2087
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
VA
Other
Enumeration date
10/18/2006
Last updated
07/08/2007
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