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General NPI Number Information
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NPI Number | 1992663868
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Entity Type | Individual
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Provider Name | KHRISTA GREZEL CARR
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Gender |
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Dates
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Enumeration Date | 01/12/2026
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 129 PINE LAKE DR
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City | HARDEEVILLE
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State | SC
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Zip | 29927-0660
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Country | US
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Telephone | 504-638-4399
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Fax |
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Provider Business Mailing Address
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Address Line | 129 PINE LAKE DR
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City | HARDEEVILLE
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State | SC
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Zip | 29927-0660
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Country | US
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Telephone | 504-638-4399
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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