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Individual

MR. RUSSELL BAXTER II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
5441 CARIBOU RIDGE DR, WATAUGA, TX 76137-4729
(972) 977-9313
Mailing address
5441 CARIBOU RIDGE DR, WATAUGA, TX 76137-4729
(972) 977-9313

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
68028
TX

Other

Enumeration date
03/10/2014
Last updated
03/10/2014
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