Individual
MRS. JULIA CAROLINE CARTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
504 E 24TH ST, TISHOMINGO, OK 73460-3214
(903) 815-0843
Mailing address
504 E 24TH ST, TISHOMINGO, OK 73460-3214
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100746580E
—
OK
Enumeration date
12/02/2010
Last updated
12/02/2010
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