Provider Demographics
NPI:1235317728
Name:BAUMANIS, RONALD PAUL (PHD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:PAUL
Last Name:BAUMANIS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 S STATE ST
Mailing Address - Street 2:SUITE 22
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-6774
Mailing Address - Country:US
Mailing Address - Phone:734-665-1922
Mailing Address - Fax:734-665-1923
Practice Address - Street 1:2900 S STATE ST
Practice Address - Street 2:SUITE 22
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-6774
Practice Address - Country:US
Practice Address - Phone:734-665-1922
Practice Address - Fax:734-665-1923
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301009602103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist