MEDICARE: MS. LAURA C. CARR LMFT, ATR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	MFC44490	CA

General Provider Information

NPI Number	:	1699901454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LAURA C. CARR LMFT, ATR

Provider Business Mailing Address
First Line	:	5199 E PACIFIC COAST HWY
Second Line	:	SUITE 612
City	:	LONG BEACH
State	:	CA
Zip	:	90804-3302
Country	:	US
Telephone Number	:	562-477-2922
Fax Number	:

Provider Business Practice Location Address
First Line	:	5199 E PACIFIC COAST HWY
Second Line	:	SUITE 612
City	:	LONG BEACH
State	:	CA
Zip	:	90804-3302
Country	:	US
Telephone Number	:	562-477-2922
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2009
Last Update Date	:	06/08/2009

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