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Individual

HEATHER LYNN BAUER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MAC, LPC

Contact information

Practice address
711 OLD BALLAS RD STE 203, SAINT LOUIS, MO 63141-7069
(314) 806-1023
Mailing address
639 HIGHVIEW CIRCLE DR, BALLWIN, MO 63021-7804
(314) 605-1460

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2010024364
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2010024364
PROVISIONAL LICENSE NUMBER
MO
Enumeration date
07/28/2010
Last updated
01/18/2022
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