Doctor Name: | DOUGLAS CARR |
NPI Number: | 1043480791 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CADC-I |
License Number: | C4003007 |
Business Practice Address: | 255 N Lincoln St Dixon, CA - 956203238 |
Business Phone Number: | 7076931733 |
Business Fax Number: | 7076931705 |
Mailing Address: | 255 N Lincoln St, DIXON |
State: | CA |
Postal Code: | 956203238 |
Phone Number: | 7076931733 |
Fax Number: | 7076931705 |
NPI Enumeration Date: | 03/10/2008 |
NPI Last Update Date: | 03/10/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | C4003007 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |