Individual
MRS. MARISSA ANNE ERRICKSON CARRAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., PH.D
Contact information
Practice address
101 HEART DR, GREENVILLE, NC 27834-8982
(252) 744-4611
(252) 744-3201
Mailing address
PO BOX 751069, CHARLOTTE, NC 28275-1069
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
4866
NC
103TH0004X
Health Psychologist
—
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669807095
—
NC
01
—
19EXB
BCBS NC
NC
Enumeration date
09/04/2013
Last updated
02/02/2024
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