Provider Demographics
NPI:1750053443
Name:GRUEN-BALDWIN, JAMIE LYNN (MA, MFT)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:LYNN
Last Name:GRUEN-BALDWIN
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:LYNN
Other - Last Name:BALDWIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, MFT
Mailing Address - Street 1:35A LUANAIKI PL
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-7112
Mailing Address - Country:US
Mailing Address - Phone:808-298-7644
Mailing Address - Fax:
Practice Address - Street 1:35A LUANAIKI PL
Practice Address - Street 2:
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-7112
Practice Address - Country:US
Practice Address - Phone:808-298-7644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-30
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist