Provider Demographics
NPI:1477264380
Name:BAUER, KARA KAATZ (PHD)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:KAATZ
Last Name:BAUER
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 1:100 S 5TH ST FL 19
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55402-1210
Mailing Address - Country:US
Mailing Address - Phone:612-482-1050
Mailing Address - Fax:
Practice Address - Street 1:100 S 5TH ST FL 19
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55402-1210
Practice Address - Country:US
Practice Address - Phone:612-482-1050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-12
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TH0100X
NY026220103TH0100X
MNLP7007103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service