Provider Demographics
NPI:1508298282
Name:BAUMAN, NATHAN (BS)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:BAUMAN
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 829
Mailing Address - Street 2:
Mailing Address - City:CHICKASHA
Mailing Address - State:OK
Mailing Address - Zip Code:73023-0829
Mailing Address - Country:US
Mailing Address - Phone:405-222-5437
Mailing Address - Fax:405-222-5441
Practice Address - Street 1:198 E ALMAR DR
Practice Address - Street 2:
Practice Address - City:CHICKASHA
Practice Address - State:OK
Practice Address - Zip Code:73018-7327
Practice Address - Country:US
Practice Address - Phone:405-222-5437
Practice Address - Fax:405-222-5441
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-05
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor