Provider Demographics
NPI:1609358878
Name:BAUDER, CHRISTINA ROSE (LPC)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:ROSE
Last Name:BAUDER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:C. ROSIE
Other - Middle Name:
Other - Last Name:BAUDER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:259 S CYPRESS AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43223-1407
Mailing Address - Country:US
Mailing Address - Phone:908-698-1111
Mailing Address - Fax:
Practice Address - Street 1:259 S CYPRESS AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43223-1407
Practice Address - Country:US
Practice Address - Phone:908-698-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1801325101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional