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Individual

DONNICA CARPENTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5417 NIGHTHAWK DR, INDIANAPOLIS, IN 46254-4766
(317) 413-1613
Mailing address
5417 NIGHTHAWK DR, INDIANAPOLIS, IN 46254-4766
(317) 413-1613

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YM0800X
Mental Health Counselor
Primary
39001974A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100270530A
IN
Enumeration date
06/05/2006
Last updated
01/06/2022
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