Individual
TOMICA MONIQUE CARR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PEER SPECIALIST
Contact information
Practice address
1817 NE 6TH AVE, PORTLAND, OR 97212-3960
(503) 719-7985
Mailing address
1817 NE 6TH AVE, PORTLAND, OR 97212-3960
(971) 804-6010
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
21-CRM-321
OR
175T00000X
Peer Specialist
—
—
261Q00000X
Clinic/Center
21-CRM-321
OR
Other
Enumeration date
10/20/2021
Last updated
10/20/2021
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