Individual
DAWN RACHELLE CARTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
19 LANVALE ST, PORT WENTWORTH, GA 31407-9763
(912) 963-6742
(912) 963-0874
Mailing address
19 LANVALE ST, PORT WENTWORTH, GA 31407-9763
(912) 963-6742
(912) 963-0874
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
652152
GA
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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