Individual
DR. KEITH BAUER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
11120 S CROWN WAY STE 1, WELLINGTON, FL 33414-8718
(561) 790-1191
Mailing address
10507 WASHINGTONIA PALM WAY APT 3821, FORT MYERS, FL 33966-6423
(239) 288-7322
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY7433
FL
Other
Enumeration date
11/01/2006
Last updated
02/07/2020
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