Provider Demographics
NPI:1952303851
Name:BAHR, DONNA MARIE (PSYD, LP)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:MARIE
Last Name:BAHR
Suffix:
Gender:F
Credentials:PSYD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:GRANITE FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56241-1438
Mailing Address - Country:US
Mailing Address - Phone:320-269-1236
Mailing Address - Fax:
Practice Address - Street 1:235 9TH AVE
Practice Address - Street 2:
Practice Address - City:GRANITE FALLS
Practice Address - State:MN
Practice Address - Zip Code:56241-1438
Practice Address - Country:US
Practice Address - Phone:320-269-1236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP 4218103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN6158642OtherMEDICA
MN04032200501OtherPRIME WEST
MNP00210475Medicare ID - Type UnspecifiedRAILROAD MEDICARE
MN122541OtherUCARE
MN1017518OtherPREFERRED ONE
MN2H939MOOtherBLUE CROSS BLUE SHIELD