Provider Demographics
NPI:1326654997
Name:BAER, RACHEAL MARIE
Entity Type:Individual
Prefix:
First Name:RACHEAL
Middle Name:MARIE
Last Name:BAER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2995 WESTLAND RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT DORA
Mailing Address - State:FL
Mailing Address - Zip Code:32757-2447
Mailing Address - Country:US
Mailing Address - Phone:724-672-7522
Mailing Address - Fax:
Practice Address - Street 1:2138 SANDRIDGE CIR
Practice Address - Street 2:
Practice Address - City:EUSTIS
Practice Address - State:FL
Practice Address - Zip Code:32726-4486
Practice Address - Country:US
Practice Address - Phone:502-741-7660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-19
Last Update Date:2020-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician