Individual
MARY KAY BAUMGARTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED.
Contact information
Practice address
335 BUCKEYE BLVD, PORT CLINTON, OH 43452-1423
(419) 734-2942
(419) 734-4922
Mailing address
335 BUCKEYE BLVD, PORT CLINTON, OH 43452-1423
(419) 734-2942
(419) 734-4922
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
976203
OH
101YP2500X
Professional Counselor
Primary
E0002358
OH
Other
Enumeration date
10/18/2011
Last updated
10/18/2011
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