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General NPI Number Information
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NPI Number | 1629706684
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Entity Type | Individual
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Provider Name | JULIANNA FAITH CARPENTER LSSP
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Gender | Female
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Dates
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Enumeration Date | 08/09/2022
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Last Update Date | 08/09/2022
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Provider Practice Location Address
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Address Line | 1003 3RD ST.
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City | LORENZO
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State | TX
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Zip | 79343
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Country | US
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Telephone | 806-634-5591
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Fax |
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Provider Business Mailing Address
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Address Line | 931 US HIGHWAY 62 207
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City | RALLS
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State | TX
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Zip | 79357-5405
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Country | US
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Telephone | 832-279-6553
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 71144
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License Number State | TX
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