Individual
MS. SUSAN MERYL BAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LMFT
Contact information
Practice address
12 TANNER WOODS, SAN ANTONIO, TX 78248-1628
(210) 394-9161
Mailing address
12 TANNER WOODS, SAN ANTONIO, TX 78248-1628
(210) 394-9161
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
09241
TX
106H00000X
Marriage & Family Therapist
Primary
611
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
044980
VALUE OPTIONS
TX
01
—
128893
MANAGED HEALTH NETWORK
TX
01
—
1507LC
BC/BS
TX
05
—
154226802
—
TX
01
—
9259574
PHCS
TX
Enumeration date
08/05/2006
Last updated
06/14/2012
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