Individual
CAROL ANN CODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
7431 114TH AVE, SUITE 104, LARGO, FL 33773-5119
(800) 632-6074
Mailing address
1025 QUAIL CIR, SALISBURY, NC 28147-8856
(704) 647-0867
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
01306
MO
103TC0700X
Clinical Psychologist
Primary
3817
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01306
STATE LICENSE
MO
01
—
3817
LICENSE
NC
05
—
6001207
—
NC
Enumeration date
04/05/2006
Last updated
07/20/2010
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