Individual
AMY GLENN BAXTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
510 US-160, ALTON, MO 65606
(360) 510-9151
(833) 415-0157
Mailing address
420 ST JOHN, THAYER, MO 65791-8500
(360) 510-9151
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2023029159
MO
101YM0800X
Mental Health Counselor
LH61301062
WA
Other
Enumeration date
08/19/2015
Last updated
03/29/2024
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