Individual
CARL SAMUEL CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S., LPES
Contact information
Practice address
1171 MARKET ST, SUITE 103, FORT MILL, SC 29708-6500
(704) 641-8902
Mailing address
1171 MARKET ST, SUITE 103, FORT MILL, SC 29708-6500
(704) 641-8902
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
4579
SC
Other
Enumeration date
07/06/2010
Last updated
07/06/2010
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