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General NPI Number Information
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NPI Number | 1952429698
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Entity Type | Individual
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Provider Name | MOLLY CARPENTER MA
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Gender | Female
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 10/08/2015
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Provider Practice Location Address
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Address Line | HIGHWAY 50 EAST & EVANS BLVD
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City | CANON CITY
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State | CO
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Zip | 81215
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Country | US
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Telephone | 719-269-5024
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Fax |
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Provider Business Mailing Address
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Address Line | 6175 EAGLES NEST DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-1506
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Country | US
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Telephone | 720-217-8869
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0011200
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License Number State | CO
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