Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | 46.004607-ASOC | CT |
Y | 103TS0200X | School Psychologist | C082020000582 | CT |
NPI | 1053908038 |
---|---|
Provider Name | Rachel Zoe Baumann |
First Address | Norwalk, CT 06851-4449 |
Second Address | Norwalk, CT 06851-4449 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/12/2020 |
Last Update Date | 24/12/2020 |