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Organization

KATHERINE J BAUM PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JENNIFER PARE (BILLER)
(802) 773-0250
Entity
Organization

Contact information

Practice address
160 BENMONT AVE, SUITE 20, BENNINGTON, VT 05201-1873
(802) 442-3520
(802) 447-3392
Mailing address
242 WILLOW RD, BENNINGTON, VT 05201-8038
(802) 442-3520
(802) 447-3392

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
0480000854
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4144421
MVP
Enumeration date
07/14/2010
Last updated
07/14/2010
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