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NPI Code Detail

MEDICARE: TRACI CARTER

MEDICARE: TRACI CARTER
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
1101YP2500XProfessional Counselor94530TX
2101YS0200XSchool Counselor1010436MN

General Provider Information

NPI Number : 1952139578
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACI CARTER
Provider Business Mailing Address
First Line : 3055 STILLHOUSE LAKE RD STE 206
Second Line :
City : HARKER HEIGHTS
State : TX
Zip : 76548-8861
Country : US
Telephone Number : 254-813-4357
Fax Number :
Provider Business Practice Location Address
First Line : 3055 STILLHOUSE LAKE RD STE 206
Second Line :
City : HARKER HEIGHTS
State : TX
Zip : 76548-8861
Country : US
Telephone Number : 254-813-4357
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2024
Last Update Date : 12/23/2024

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Directions to “ TRACI CARTER ” Practice Location

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