| Doctor Name: | ANNE M CARLSON |
| NPI Number: | 1306032941 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 20042154A |
| Business Practice Address: | 41 N Long Avenue Attica, IN - 47918 |
| Business Phone Number: | 7657626187 |
| Business Fax Number: | |
| Mailing Address: | 3480 Burnley Dr, W LAFAYETTE |
| State: | IN |
| Postal Code: | 479068701 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 09/18/2007 |
| NPI Last Update Date: | 09/18/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 20042154A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |