Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 6801090812 | MI |
NPI | 1003255118 |
---|---|
Provider Name | Maureen D Bauschke |
First Address | Kalamazoo, MI 49007-3858 |
Second Address | Kalamazoo, MI 49007-3858 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2013 |
Last Update Date | 03/01/2020 |