Organization
JODI L. CARSON NURSE PRACTITIONER IN PSYCHIATRY
Active
Other names
Tree of Life Total Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
JODI L CARSON NP (OWNER)
(518) 416-0359
Entity
Organization
Contact information
Practice address
939 ROUTE 146 STE 620, CLIFTON PARK, NY 12065-3629
(518) 414-5706
Mailing address
641 GROOMS RD # 130, CLIFTON PARK, NY 12065-5912
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1609521145
—
NY
Enumeration date
11/25/2024
Last updated
01/07/2025
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