Individual
MARY MARGARET CARNAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPE
Contact information
Practice address
7485 STATE ROAD 64, GEORGETOWN, IN 47122-8735
(501) 538-8274
Mailing address
1440 SAINT JOHNS CHURCH RD NE, LANESVILLE, IN 47136-8536
(501) 538-8274
(708) 845-5505
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
11-01EI
AR
101YP2500X
Professional Counselor
180.009927
IL
101YP2500X
Professional Counselor
Primary
39003461A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116399726
—
AR
Enumeration date
08/17/2009
Last updated
04/18/2019
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