Doctor Name: | MRS. KARRIE MICHELLE MACE |
NPI Number: | 1821162488 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A., ED.S |
License Number: | |
Business Practice Address: | 242 Church Street Clay, WV - 250430120 |
Business Phone Number: | 3045872713 |
Business Fax Number: | 3045874181 |
Mailing Address: | Po Box 120, CLAY |
State: | WV |
Postal Code: | 250430120 |
Phone Number: | 3045872713 |
Fax Number: | 3045874181 |
NPI Enumeration Date: | 11/17/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TS0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | School |
Taxonomy Definition: |