Provider Demographics
NPI:1780388892
Name:BAUMAN, CONNIE ARLENE (BA, MT, DOULA)
Entity type:Individual
Prefix:MS
First Name:CONNIE
Middle Name:ARLENE
Last Name:BAUMAN
Suffix:
Gender:F
Credentials:BA, MT, DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3620 F ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95503-5348
Mailing Address - Country:US
Mailing Address - Phone:707-845-5489
Mailing Address - Fax:
Practice Address - Street 1:735 12TH ST
Practice Address - Street 2:
Practice Address - City:ARCATA
Practice Address - State:CA
Practice Address - Zip Code:95521-5865
Practice Address - Country:US
Practice Address - Phone:707-845-5489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
894192OtherASSOCIATED BODYWORK & MASSAGE PROFESSIONALS (ABMP)