Provider Demographics
NPI:1932684628
Name:BAUMGARDNER, ANN HUDSON (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:HUDSON
Last Name:BAUMGARDNER
Suffix:
Gender:F
Credentials:PHD
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 111
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22747-0111
Mailing Address - Country:US
Mailing Address - Phone:540-671-0980
Mailing Address - Fax:
Practice Address - Street 1:311 GAY ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:VA
Practice Address - Zip Code:22747-1982
Practice Address - Country:US
Practice Address - Phone:540-671-0980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-27
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701007916101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional