Individual
DR. MICHAEL C. BAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1003 MARTIN LUTHER KING DR, BLOOMINGTON, IL 61701-1429
(309) 820-3500
Mailing address
1106 E MONROE ST, BLOOMINGTON, IL 61701-3329
(309) 828-3770
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
IL
Other
Enumeration date
03/23/2007
Last updated
07/08/2007
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