Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | MH8720 | FL |
N | 101YP1600X | Pastoral Counselor | MH8720 | FL |
NPI | 1215033360 |
---|---|
Provider Name | Dr. Alexander J. Baer |
First Address | Daytona Beach, FL 32118-4616 |
Second Address | Daytona Beach, FL 32118-4616 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2006 |
Last Update Date | 08/07/2007 |