Individual
QWENETRA GEORGETTE CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1102 WINKLER AVE, KILLEEN, TX 76542-6249
(254) 634-8505
(254) 781-4312
Mailing address
605 DONNIE AVE, KILLEEN, TX 76541-8918
(254) 634-8505
(254) 781-4312
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
5201009933
MI
225XP0200X
Pediatric Occupational Therapist
Primary
114027
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
114027
STATE LICENSE NUMBER
TX
Enumeration date
04/05/2011
Last updated
11/13/2018
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