Provider Demographics
NPI:1700095296
Name:BAUMAN, LISA MARIE (MT-BC, WMTR)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:MARIE
Last Name:BAUMAN
Suffix:
Gender:F
Credentials:MT-BC, WMTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W285S3836 SANDPIPER BR
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53189-8923
Mailing Address - Country:US
Mailing Address - Phone:262-968-3415
Mailing Address - Fax:
Practice Address - Street 1:W285S3836 SANDPIPER BR
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53189-8923
Practice Address - Country:US
Practice Address - Phone:262-968-3415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI35-38225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist