Provider Demographics
NPI:1558492561
Name:THOMAS-BAUN, SUSAN JEAN (MA)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:JEAN
Last Name:THOMAS-BAUN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MISS
Other - First Name:SUSAN
Other - Middle Name:JEAN
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:70 MARWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15241-2322
Mailing Address - Country:US
Mailing Address - Phone:412-831-7694
Mailing Address - Fax:412-831-7694
Practice Address - Street 1:200 OLD POND RD
Practice Address - Street 2:
Practice Address - City:BRIDGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15017-1269
Practice Address - Country:US
Practice Address - Phone:412-220-0144
Practice Address - Fax:412-220-0146
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS007935L103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling