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Individual

MS. LISA DIANE BAXTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
350 E WASHINGTON ST UNIT C, WALTERBORO, SC 29488-3982
(843) 419-7576
(843) 552-5122
Mailing address
106 CEDAR GROVE DR, NORTH CHARLESTON, SC 29420-8146
(843) 568-3946
(843) 552-5122

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
969
SC

Other

Enumeration date
11/17/2011
Last updated
02/13/2014
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