Healthcare Provider Details

I. General information

NPI: 1437084647
Provider Name (Legal Business Name): CECILIA BAXTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5622 SNOWDRIFT RD
OREFIELD PA
18069-8912
US

IV. Provider business mailing address

5622 SNOWDRIFT RD
OREFIELD PA
18069-8912
US

V. Phone/Fax

Practice location:
  • Phone: 610-360-7332
  • Fax:
Mailing address:
  • Phone: 610-360-7332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAPC000089
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: