Individual
GRANT BAUSTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY D
Contact information
Practice address
733 W CLAIREMONT AVE, EAU CLAIRE, WI 54701-6101
(715) 838-5222
Mailing address
1400 BELLINGER ST, EAU CLAIRE, WI 54703-5222
(715) 838-5222
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
2822-57
WI
Other
Enumeration date
08/20/2009
Last updated
03/19/2013
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