Provider Demographics
NPI:1528825437
Name:BAUER ABA THERAPY LLC
Entity type:Organization
Organization Name:BAUER ABA THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAUER
Authorized Official - Suffix:
Authorized Official - Credentials:ECE
Authorized Official - Phone:510-846-2295
Mailing Address - Street 1:920 BAYSWATER AVE APT 234
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-3140
Mailing Address - Country:US
Mailing Address - Phone:510-846-2295
Mailing Address - Fax:
Practice Address - Street 1:920 BAYSWATER AVE APT 234
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-3140
Practice Address - Country:US
Practice Address - Phone:510-846-2295
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency