Provider Demographics
NPI:1649490921
Name:BAER, DENISE ANN (CMT)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:ANN
Last Name:BAER
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 N AUGUSTA CT STE 109
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-7719
Mailing Address - Country:US
Mailing Address - Phone:507-469-8741
Mailing Address - Fax:
Practice Address - Street 1:120 N AUGUSTA CT STE 109
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-7719
Practice Address - Country:US
Practice Address - Phone:507-469-8741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-27
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist