Individual
WILLIAM RUSSELL CARTER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD, LP
Contact information
Practice address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4264
(417) 761-5000
(417) 761-5011
Mailing address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4264
(417) 761-5000
(417) 761-5011
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
01468
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
499615201
—
MO
Enumeration date
05/01/2012
Last updated
01/25/2021
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