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Nicolle M Bauer Lmhc

Counselor, Mental Health in St Augustine, FL. Organization (NPI-2).

NPI number1982140307
StatusActive
Last updated in NPPESJan 9, 2017

Details

NPI
1982140307
Entity type
Organization (NPI-2)
Legal business name
Nicolle M Bauer Lmhc
Organization subpart
No
Enumeration date
Jan 9, 2017
Last updated
Jan 9, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YM0800X Counselor, Mental HealthMH6243FLYes

Practice location

2200 N Ponce De Leon Blvd
Ste 3
St Augustine, FL 32084-2600

Phone 904-501-8270 · Fax 904-819-5330

Mailing address

2200 N Ponce De Leon Blvd
Ste 3
St Augustine, FL 32084-2600

Phone 904-501-8270 · Fax 904-819-5330

Authorized official

Nicolle M Bauer
Owner
9045018270

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