Provider Demographics
NPI:1770220436
Name:BAER, JERI (AUD)
Entity Type:Individual
Prefix:
First Name:JERI
Middle Name:
Last Name:BAER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:JERI
Other - Middle Name:
Other - Last Name:WONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:872 POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17815-2872
Mailing Address - Country:US
Mailing Address - Phone:845-674-3385
Mailing Address - Fax:
Practice Address - Street 1:100 SCHUYLKILL MEDICAL PLZ STE 203
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-3767
Practice Address - Country:US
Practice Address - Phone:570-621-5005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-15
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist