Provider Demographics
NPI:1689126922
Name:BAXTER, LAURA (MS)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:
Last Name:BAXTER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 CHESTNUT LAND RD
Mailing Address - Street 2:
Mailing Address - City:NEW MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06776-2200
Mailing Address - Country:US
Mailing Address - Phone:860-733-9972
Mailing Address - Fax:
Practice Address - Street 1:375 CHESTNUT LAND RD
Practice Address - Street 2:
Practice Address - City:NEW MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06776-2200
Practice Address - Country:US
Practice Address - Phone:860-733-9972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-03
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor