Baxter, Stephanie Dianne

Baxter, Stephanie Dianne is an individual health care provider with primary practice located at 831 12Th Ave , Longview WA 98632-2403. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Social Worker. Behavioral Health & Social Service Providers / Social Worker is her primary health care specialty. Baxter, Stephanie Dianne can be contacted via phone (360) 998-2349.

Contact Information

Primary practice address
831 12Th Ave Longview WA 98632-2403
Fax: (360) 998-2887
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X SC60614734 Washington
Behavioral Health & Social Service Providers / Social Worker 104100000X LW60990251 Washington

Profile Details

NPI number 1952965279
LBN Legal business name Baxter, Stephanie Dianne
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 23rd, 2019
Last updated Oct 31st, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952965279 NPPES
Washington MEDICAID 2146977

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