Individual
JACQUELINE RENEE BAUER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
10701 MAIN STREET, FAIRFAX, VA 22030
(703) 273-7705
Mailing address
103 ALMEY COURT, STERLING, VA 20164
(703) 973-5402
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
03/01/2018
Last updated
03/01/2018
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