Doctor Name: | MRS. LESA H CARTER |
NPI Number: | 1356521702 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CPCI |
License Number: | 6796409-6009 |
Business Practice Address: | 55 S 500 E Heber City, UT - 840321918 |
Business Phone Number: | 4356573297 |
Business Fax Number: | 4356541646 |
Mailing Address: | 133 S 550 E, MIDWAY |
State: | UT |
Postal Code: | 840496709 |
Phone Number: | 4356572722 |
Fax Number: | |
NPI Enumeration Date: | 11/13/2007 |
NPI Last Update Date: | 11/13/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 6796409-6009 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |