Provider Demographics
NPI:1952683583
Name:BAUMAN, MARGARET SUZANNE (LMFT)
Entity Type:Individual
Prefix:MISS
First Name:MARGARET
Middle Name:SUZANNE
Last Name:BAUMAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:MEG
Other - Middle Name:
Other - Last Name:BAUMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:619 W PARK AVE
Mailing Address - Street 2:
Mailing Address - City:CHECOTAH
Mailing Address - State:OK
Mailing Address - Zip Code:74426-1419
Mailing Address - Country:US
Mailing Address - Phone:918-616-1700
Mailing Address - Fax:918-473-3185
Practice Address - Street 1:619 W PARK AVE
Practice Address - Street 2:
Practice Address - City:CHECOTAH
Practice Address - State:OK
Practice Address - Zip Code:74426-1419
Practice Address - Country:US
Practice Address - Phone:918-616-1700
Practice Address - Fax:918-473-3185
Is Sole Proprietor?:No
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK876106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100745880Medicaid