Individual
BETH AILEEN BAXTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2201 RIDGEWOOD RD, WYOMISSING, WYOMISSING, PA 19610-1189
(610) 378-9601
(610) 378-3610
Mailing address
2201 RIDGEWOOD RD, WYOMISSING, WYOMISSING, PA 19610-1189
(610) 378-9601
(610) 378-3610
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW015493
PA
106H00000X
Marriage & Family Therapist
CW015493
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CS015493
CLNICAL SOCIAL WORKER
PA
Enumeration date
11/03/2006
Last updated
10/30/2008
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