Individual
REBECCA SUE BAUMGARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED., OTR/L
Contact information
Practice address
2715 LILAC ST, LONGVIEW, WA 98632-3526
(360) 575-7008
Mailing address
2715 LILAC ST, LONGVIEW, WA 98632-3526
(360) 575-7008
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
5474
OR
225XP0200X
Pediatric Occupational Therapist
Primary
OT00001967
WA
Other
Enumeration date
08/30/2012
Last updated
08/30/2012
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