Provider Demographics
NPI:1982916730
Name:BAUER, CASEY ANN (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:ANN
Last Name:BAUER
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 1:118 E MINER ST
Mailing Address - Street 2:APARTMENT 2
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-3124
Mailing Address - Country:US
Mailing Address - Phone:570-575-9678
Mailing Address - Fax:
Practice Address - Street 1:118 E MINER ST
Practice Address - Street 2:APARTMENT 2
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-3124
Practice Address - Country:US
Practice Address - Phone:570-575-9678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-09
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL009688235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist