Individual
KEN BAUMGARTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.ED
Contact information
Practice address
906 W UNIVERSITY AVE, SUITE 120, FLAGSTAFF, AZ 86001-2986
(928) 522-3780
(928) 563-0048
Mailing address
PO BOX 2923, FLAGSTAFF, AZ 86003-2923
(928) 864-7165
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-15-21214
AZ
Other
Enumeration date
09/30/2015
Last updated
03/11/2016
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