Individual
PHYLLIS ANN KING-CARR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
11508 MACALPINE CT APT 838, GLEN ALLEN, VA 23059-5567
(804) 929-1277
Mailing address
11508 MACALPINE CT APT 838, GLEN ALLEN, VA 23059-5567
(804) 929-1277
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
T67160496
DRIVERS LICENSE
VA
Enumeration date
02/16/2023
Last updated
02/16/2023
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