Individual
SUSAN CARRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., LPA
Contact information
Practice address
205 PLAZA DR, SUITE C, GREENVILLE, NC 27858-6752
(252) 756-1316
Mailing address
205 PLAZA DR, SUITE C, GREENVILLE, NC 27858-6752
(252) 756-1316
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2268
NC
Other
Enumeration date
07/26/2013
Last updated
07/26/2013
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