Provider Demographics
NPI:1003156712
Name:BAUMAN, MARGARET FRANCES (LISAC)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:FRANCES
Last Name:BAUMAN
Suffix:
Gender:F
Credentials:LISAC
Other - Prefix:MS
Other - First Name:PEGGY
Other - Middle Name:
Other - Last Name:BAUMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LISAC
Mailing Address - Street 1:10320 W MCDOWELL RD
Mailing Address - Street 2:STE. G-7024
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-4863
Mailing Address - Country:US
Mailing Address - Phone:602-258-6797
Mailing Address - Fax:623-936-4085
Practice Address - Street 1:10320 W MCDOWELL RD
Practice Address - Street 2:STE. G-7024
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-4863
Practice Address - Country:US
Practice Address - Phone:602-258-6797
Practice Address - Fax:623-936-4085
Is Sole Proprietor?:No
Enumeration Date:2013-02-18
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLISAC-10124101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)