Provider Information for 1295559490
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DAMETRIA CARSON LPC
Sex: Female
NPI: 1295559490
Last Updated: 2024-11-13
Certification Date: 2024-11-13
Certification Date: 2024-11-13
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1295559490 | ||||||||
| Enumeration Date | 2024-11-13 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 3895 MOUNTAIN VIEW RD NW KENNESAW, GA 30152-2388 United States Phone: 404-314-7889 | Fax: | ||||||||
| Primary Practice Address | 3895 MOUNTAIN VIEW RD NW KENNESAW, GA 30152-2388 United States Phone: 404-314-7889 | Fax: | ||||||||
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