Healthcare Provider Details

I. General information

NPI: 1376319095
Provider Name (Legal Business Name): CARRIE L LONES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2023
Last Update Date: 12/04/2023
Certification Date: 12/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 JOHNSTON ST SE STE 100
DECATUR AL
35601-2535
US

IV. Provider business mailing address

251 JOHNSTON ST SE STE 100
DECATUR AL
35601-2535
US

V. Phone/Fax

Practice location:
  • Phone: 256-822-2375
  • Fax: 256-584-2330
Mailing address:
  • Phone: 256-822-2375
  • Fax: 256-584-2330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: