Provider Demographics
NPI:1376937508
Name:BAUHOF, LAURA A (PHD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:A
Last Name:BAUHOF
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 S NAPERVILLE RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60189-5805
Mailing Address - Country:US
Mailing Address - Phone:630-480-7005
Mailing Address - Fax:
Practice Address - Street 1:1725 S NAPERVILLE RD
Practice Address - Street 2:SUITE 207
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60189-5805
Practice Address - Country:US
Practice Address - Phone:630-480-7005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-25
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.008985103TC0700X
OH6866103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical