Provider Demographics
NPI:1649661554
Name:BAER, AMBER
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:BAER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 RIDGEVIEW LN
Mailing Address - Street 2:
Mailing Address - City:MAINEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45039-8021
Mailing Address - Country:US
Mailing Address - Phone:513-398-8050
Mailing Address - Fax:513-494-1469
Practice Address - Street 1:50 RIDGEVIEW LN
Practice Address - Street 2:
Practice Address - City:MAINEVILLE
Practice Address - State:OH
Practice Address - Zip Code:45039-8021
Practice Address - Country:US
Practice Address - Phone:513-398-8050
Practice Address - Fax:513-494-1469
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-13
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH1352463103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool