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Individual
THERESA PAYNTER BAXTER
Active
Individual
THERESA PAYNTER BAXTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
81099
CA
225100000X
Physical Therapist
12659
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0PT126591
MEDICARE PTAN
CA
Enumeration date
10/16/2006
Last updated
01/14/2018
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