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Individual
DR. THERESA LYNN CARRASCO
Active
Individual
DR. THERESA LYNN CARRASCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302040485
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5302040485
PHARMACIST PRECEPTOR
MI
01
—
5315123413
CS - PHARMACIST
MI
Enumeration date
07/30/2015
Last updated
06/13/2022
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