Provider Demographics
NPI:1407256183
Name:BAXTER, WINNIFRED
Entity Type:Individual
Prefix:MISS
First Name:WINNIFRED
Middle Name:
Last Name:BAXTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1234 FLINT STREET EXT
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-6329
Mailing Address - Country:US
Mailing Address - Phone:803-981-1085
Mailing Address - Fax:
Practice Address - Street 1:1234 FLINT STREET EXT
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-6329
Practice Address - Country:US
Practice Address - Phone:803-981-1085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-29
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist