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General NPI Number Information
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NPI Number | 1982303400
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Entity Type | Individual
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Provider Name | DASHA CARVER MA
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Gender | Female
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Dates
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Enumeration Date | 02/23/2023
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Last Update Date | 02/23/2023
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Provider Practice Location Address
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Address Line | 120 W 7TH ST STE 108
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City | BLOOMINGTON
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State | IN
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Zip | 47404-3835
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Country | US
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Telephone | 812-269-6966
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Fax |
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Provider Business Mailing Address
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Address Line | 2715 S BOARDWALK CIR APT 308
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City | BLOOMINGTON
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State | IN
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Zip | 47403-3499
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Country | US
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Telephone | 314-853-8105
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 99116812A
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License Number State | IN
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