Provider Demographics
NPI:1740525500
Name:BAERENWALD, MARIA PAULA (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:PAULA
Last Name:BAERENWALD
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4129 SW 328TH ST
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-2628
Mailing Address - Country:US
Mailing Address - Phone:253-815-9178
Mailing Address - Fax:
Practice Address - Street 1:4129 SW 328TH ST
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98023-2628
Practice Address - Country:US
Practice Address - Phone:253-815-9178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-05
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00003335235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist