Healthcare Provider Details

I. General information

NPI: 1447171293
Provider Name (Legal Business Name): FATIA ANIA CARTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8330 N 46TH ST APT 116
BROWN DEER WI
53223-3749
US

IV. Provider business mailing address

8330 N 46TH ST APT 116
BROWN DEER WI
53223-3749
US

V. Phone/Fax

Practice location:
  • Phone: 414-308-7399
  • Fax:
Mailing address:
  • Phone: 414-308-7399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number2700817
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: