Individual
MS. GWEN BAUER TRADER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSWC
Contact information
Practice address
8615 RIDGELYS CHOICE DR, STE 212 RENEWAL COUNSELING CENTER, BALTIMORE, MD 21236
(410) 529-2151
(410) 529-1342
Mailing address
8615 RIDGELYS CHOICE DR, STE 212, BALTIMORE, MD 21236
(410) 529-2151
(410) 529-1342
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
06580
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KL86
BCBS
MD
Enumeration date
12/08/2006
Last updated
07/08/2007
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