Individual
MRS. MICHELE MOORE BAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1044 NORTHWEST BLVD STE C, COEUR D ALENE, ID 83814-2114
(208) 930-1740
(208) 930-1695
Mailing address
1044 NORTHWEST BLVD STE C, COEUR D ALENE, ID 83814-2114
(208) 930-1740
(208) 930-1695
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW28311
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1932320843
NPI
—
Enumeration date
05/01/2007
Last updated
10/01/2019
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