Individual
DR. KENNETH LEE CARRICO, JR. JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1001 E UNION ST STE B, MORGANTON, NC 28655-2863
(828) 438-6226
(828) 438-6225
Mailing address
3050 11TH AVENUE DR SE, HICKORY, NC 28602-8336
(828) 695-5900
(828) 695-4256
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3289
NC
103TC0700X
Clinical Psychologist
P00956
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6000931
—
NC
Enumeration date
08/19/2006
Last updated
07/09/2007
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