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General NPI Number Information
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NPI Number | 1760783187
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Entity Type | Individual
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Provider Name | DEETTA M ROBERSON CARTER LCSWC
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Gender | Female
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Dates
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Enumeration Date | 11/17/2010
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Last Update Date | 08/12/2013
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Provider Practice Location Address
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Address Line | 17 WARREN ROAD SUITE 25A
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City | PIKESVILLE
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State | MD
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Zip | 21208
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Country | US
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Telephone | 410-701-0770
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Fax | 443-279-2916
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Provider Business Mailing Address
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Address Line | 17 WARREN ROAD SUITE 25A
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City | PIKESVILLE
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State | MD
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Zip | 21208
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Country | US
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Telephone | 410-701-0770
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Fax | 443-279-2916
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | G12345
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 17501
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License Number State | MD
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