Individual
IRIS RAE BAUGHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
110 REGENT CT, SUITE 103, STATE COLLEGE, PA 16801
(814) 237-0551
(814) 237-0564
Mailing address
110 REGENT CT, SUITE 103, STATE COLLEGE, PA 16801
(814) 237-0551
(814) 237-0564
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS0057406
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1381981
BS
PA
01
—
50000769
CAPITAL BC
PA
Enumeration date
09/21/2006
Last updated
07/08/2007
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