| Doctor Name: | DR. CAROLE S LIGHT |
| NPI Number: | 1639288517 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PND |
| License Number: | 297 |
| Business Practice Address: | 318 Lakeside Rd Scaly Mountain, NC - 287750099 |
| Business Phone Number: | 8285269769 |
| Business Fax Number: | 8285268719 |
| Mailing Address: | Po Box 99, 318 Lakeside Rd SCALY MOUNTAIN |
| State: | NC |
| Postal Code: | 287750099 |
| Phone Number: | 8285269769 |
| Fax Number: | 8285268719 |
| NPI Enumeration Date: | 08/30/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 297 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |