Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003365172 |
---|---|
Provider Name | Victoria Baxter |
First Address | Raleigh, NC 27606-1672 |
Second Address | Raleigh, NC 27606-1672 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2016 |
Last Update Date | 16/07/2020 |