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Individual

KEITH ALAN BAUER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD, LCSW

Contact information

Practice address
327 N WASHINGTON AVE, PULASKI, VA 24301-5009
(540) 994-5023
(540) 994-5028
Mailing address
700 UNIVERSITY CITY BLVD, BLACKSBURG, VA 24060-2706
(540) 961-8300
(540) 961-8465

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904010982
VA

Other

Enumeration date
03/15/2019
Last updated
03/15/2019
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