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Individual

MRS. CARRIE MAE CARPENTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
371 LEAR RD, AVON LAKE, OH 44012-2095
(440) 225-4151
Mailing address
854 ROBERTS ST, SHEFFIELD LAKE, OH 44054-2030
(440) 864-4025

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2087281
OH
Enumeration date
12/05/2006
Last updated
07/09/2007
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