Doctor Name: | JODI LEIGH CARLTON |
NPI Number: | 1396820387 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MED, LPC, NCC |
License Number: | LPC003878 |
Business Practice Address: | 80 Ridgeview Dr Se Silver Creek, GA - 301732326 |
Business Phone Number: | 7062967958 |
Business Fax Number: | 8666512192 |
Mailing Address: | 80 Ridgeview Dr Se, SILVER CREEK |
State: | GA |
Postal Code: | 301732326 |
Phone Number: | 7062967958 |
Fax Number: | 8666512192 |
NPI Enumeration Date: | 10/26/2006 |
NPI Last Update Date: | 10/14/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LPC003878 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |