Individual
CARRIE ELLEN STAPLETON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
1021 4TH AVE, SHALIMAR, FL 32579-1983
(850) 613-6150
Mailing address
1021 4TH AVE, SHALIMAR, FL 32579-1983
(850) 613-6150
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH-5553
FL
Other
Enumeration date
01/25/2007
Last updated
07/08/2007
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