Doctor Name: | CAROL MARIE STE CLAIRE |
NPI Number: | 1255421574 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.M.H.C. |
License Number: | MH4422 |
Business Practice Address: | 820 Turtle Lake Ct Ponte Vedra, FL - 320824566 |
Business Phone Number: | 9048271899 |
Business Fax Number: | 9048271899 |
Mailing Address: | 820 Turtle Lake Ct, PONTE VEDRA |
State: | FL |
Postal Code: | 320824566 |
Phone Number: | 9048271899 |
Fax Number: | 9048271899 |
NPI Enumeration Date: | 10/15/2006 |
NPI Last Update Date: | 02/22/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | MH4422 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |