Provider Demographics
NPI:1528710233
Name:BAXTER, ELIZABETH M (SWLC)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:M
Last Name:BAXTER
Suffix:
Gender:F
Credentials:SWLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 6TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:RONAN
Mailing Address - State:MT
Mailing Address - Zip Code:59864-2600
Mailing Address - Country:US
Mailing Address - Phone:406-676-3600
Mailing Address - Fax:406-676-3637
Practice Address - Street 1:126 6TH AVE SW
Practice Address - Street 2:
Practice Address - City:RONAN
Practice Address - State:MT
Practice Address - Zip Code:59864-2600
Practice Address - Country:US
Practice Address - Phone:406-676-3600
Practice Address - Fax:406-676-3637
Is Sole Proprietor?:No
Enumeration Date:2022-01-24
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT53891104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker