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General NPI Number Information
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NPI Number | 1215642210
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Entity Type | Individual
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Provider Name | CARLY PERCY MA, TLLP
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Gender | Female
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Dates
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Enumeration Date | 01/16/2023
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 1286 S LINDEN RD STE B
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City | FLINT
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State | MI
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Zip | 48532-3457
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Country | US
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Telephone | 810-407-7403
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Fax |
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Provider Business Mailing Address
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Address Line | 816 SILVER CREEK RD
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City | MARQUETTE
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State | MI
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Zip | 49855-8970
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Country | US
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Telephone | 480-215-6586
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6351004875
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License Number State | MI
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