Individual
MS. CAROL LOUISE AMELINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
331 SIJAN AVE, WHITEMAN AFB, MO 65305-1269
(660) 687-3484
Mailing address
331 SIJAN AVE, WHITEMAN AFB, MO 65305-1269
(660) 687-3484
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
54161
TX
Other
Enumeration date
04/18/2013
Last updated
11/12/2021
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