Provider Demographics
NPI:1518022516
Name:BAUMGARTNER, RENEE DAWN (CMT)
Entity Type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:DAWN
Last Name:BAUMGARTNER
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:WISCONSIN DELLS
Mailing Address - State:WI
Mailing Address - Zip Code:53965-1512
Mailing Address - Country:US
Mailing Address - Phone:608-254-7537
Mailing Address - Fax:
Practice Address - Street 1:610 CEDAR ST
Practice Address - Street 2:
Practice Address - City:WISCONSIN DELLS
Practice Address - State:WI
Practice Address - Zip Code:53965-1512
Practice Address - Country:US
Practice Address - Phone:608-254-7537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2219-046174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist