Individual
JENNIFER BAUER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
442 LA COSTA LN, JOHNSTOWN, CO 80534-9066
(970) 590-6206
Mailing address
442 LA COSTA LN, JOHNSTOWN, CO 80534-9066
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP.0001419
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
92203761
—
CO
Enumeration date
05/23/2016
Last updated
10/04/2021
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