Individual
CASSANDRA LEANNE BAXTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MACC
Contact information
Practice address
3411 W DIVERSEY AVE, CHICAGO, IL 60647-1245
(224) 534-0331
Mailing address
1501 N TALMAN AVE, CHICAGO, IL 60622-7353
(773) 494-3733
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
178.011145
IL
Other
Enumeration date
09/15/2023
Last updated
09/15/2023
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