Basic Information
Provider Information
NPI: 1033556378
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BAER
FirstName: JANICE
MiddleName: B
NamePrefix: MS.
NameSuffix:  
Credential: LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 707 ALEXANDER RD
Address2: SUITE 102
City: PRINCETON
State: NJ
PostalCode: 085406331
CountryCode: US
TelephoneNumber: 6099878100
FaxNumber: 6099870574
Practice Location
Address1: 707 ALEXANDER RD
Address2: SUITE 102
City: PRINCETON
State: NJ
PostalCode: 085406331
CountryCode: US
TelephoneNumber: 6099878100
FaxNumber: 6099870574
Other Information
ProviderEnumerationDate: 05/28/2013
LastUpdateDate: 05/28/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X44SC01480400NJY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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