Individual
MRS. TERRY CARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3090 123
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
391398029028
BLUE CROSS BLUE SHIELD
WI
01
—
930564044001
BLUE CROSS BLUE SHIELD
WI
Enumeration date
08/10/2007
Last updated
08/10/2007
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