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General NPI Number Information
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NPI Number | 1285708842
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Entity Type | Individual
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Provider Name | TONIA CARROLL KASPER LCSW, RPT
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Gender | Female
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 09/12/2011
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Provider Practice Location Address
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Address Line | 111 CEDAR LN
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City | STARKVILLE
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State | MS
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Zip | 39759-2617
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Country | US
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Telephone | 662-418-0692
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Fax |
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Provider Business Mailing Address
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Address Line | 309 E LAMPKIN ST
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City | STARKVILLE
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State | MS
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Zip | 39759-2909
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Country | US
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Telephone | 662-418-0692
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C5767
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License Number State | MS
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