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Individual

TARA M BAUMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LADC LGSW

Contact information

Practice address
15320 MINNETONKA BLVD #200, MINNETONKA, MN 55345
(952) 932-7277
(952) 932-9827
Mailing address
15320 MINNETONKA BLVD #200, MINNETONKA, MN 55345
(952) 932-7277
(952) 932-9827

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
302123
MN

Other

Enumeration date
02/08/2007
Last updated
07/08/2007
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