Doctor Name: | CHARITY U CARROLL |
NPI Number: | 1043644727 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A |
License Number: | |
Business Practice Address: | 3700 W Kilgore Ave Muncie, IN - 473044810 |
Business Phone Number: | 7652895437 |
Business Fax Number: | |
Mailing Address: | 3700 W Kilgore Ave, MUNCIE |
State: | IN |
Postal Code: | 473044810 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 08/29/2013 |
NPI Last Update Date: | 08/29/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |