Provider Demographics
NPI:1295138337
Name:BAUSE, TAWNY (MS)
Entity type:Individual
Prefix:
First Name:TAWNY
Middle Name:
Last Name:BAUSE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:TAWNY
Other - Middle Name:
Other - Last Name:SANDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:950 LEE ST STE 210
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-6574
Mailing Address - Country:US
Mailing Address - Phone:847-486-4140
Mailing Address - Fax:
Practice Address - Street 1:120 PRECISION UNIT A100
Practice Address - Street 2:
Practice Address - City:BUDA
Practice Address - State:TX
Practice Address - Zip Code:78610-5823
Practice Address - Country:US
Practice Address - Phone:512-354-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-15-19241103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst