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NPI Code Detail

MEDICARE: MS. CATHY LEE CARR NONE

MEDICARE: MS. CATHY LEE CARR NONE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11367OTHERCACOUSELOR

General Provider Information

NPI Number : 1467675942
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CATHY LEE CARR NONE
Provider Business Mailing Address
First Line : 1410 GUERNEVILLE RD
Second Line : 14
City : SANTA ROSA
State : CA
Zip : 95403-7231
Country : US
Telephone Number : 707-575-0979
Fax Number : 707-573-6968
Provider Business Practice Location Address
First Line : 634 PRESSLEY ST
Second Line :
City : SANTA ROSA
State : CA
Zip : 95404-5526
Country : US
Telephone Number : 707-573-6955
Fax Number : 707-573-8176
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2007
Last Update Date : 06/15/2012

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Directions to “ MS. CATHY LEE CARR NONE” Practice Location

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