Individual
CAMDEN L BAUCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3249 BROAD ST STE 1, DEXTER, MI 48130-1018
(734) 219-3907
(734) 418-9110
Mailing address
3249 BROAD ST STE 1, DEXTER, MI 48130-1018
(734) 219-3907
(734) 418-9110
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6361007949
MI
171M00000X
Case Manager/Care Coordinator
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000
LICENSURE BOARD
OH
Enumeration date
06/12/2018
Last updated
01/22/2026
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