Provider Demographics
NPI:1417953977
Name:BAUER, INGA MARY (OSF, LMFT)
Entity Type:Individual
Prefix:
First Name:INGA
Middle Name:MARY
Last Name:BAUER
Suffix:
Gender:F
Credentials:OSF, LMFT
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:MARY
Other - Last Name:BAUER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:506 E 23RD AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-2344
Mailing Address - Country:US
Mailing Address - Phone:509-838-8422
Mailing Address - Fax:
Practice Address - Street 1:1016 N SUPERIOR ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-2059
Practice Address - Country:US
Practice Address - Phone:509-483-6495
Practice Address - Fax:509-483-1541
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00001181106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist