Provider Information for 1902883283
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MARTHA SUSAN CARTER LICSW
Sex: Female
NPI: 1902883283
Last Updated: 2018-01-04
Certification Date:
Certification Date:
Details
Name | Value | ||||||||||||
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NPI | 1902883283 | ||||||||||||
Enumeration Date | 2005-12-28 | ||||||||||||
NPI Type | NPI-1 Individual | ||||||||||||
Sole Proprietor | NO | ||||||||||||
Status | Active | ||||||||||||
Mailing Address | 2550 UNIVERSITY AVENUE WEST SUITE 229N ST PAUL, MN 55114 United States Phone: 651-645-3115 | Fax:654-645-2752 | ||||||||||||
Primary Practice Address | 2925 CHICAGO AVE MINNEAPOLIS, MN 55407-1321 United States Phone: 612-863-8511 | Fax:612-863-8516 | ||||||||||||
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