Individual
HOLLY BAUER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
610 GOLD AVE SW, ALBUQUERQUE, NM 87102-3146
(505) 219-1125
Mailing address
2308 GANDERT AVE SE, ALBUQUERQUE, NM 87106-9607
(505) 610-3610
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C-08531
NM
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
I-08531
NM
Other
Enumeration date
11/19/2014
Last updated
04/29/2022
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