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NPI Code Detail

MEDICARE: ERICA MORGAN CARBONELL

MEDICARE:   ERICA MORGAN CARBONELL
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
1103TS0200XSchool Psychologist4812SC

General Provider Information

NPI Number : 1912743378
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERICA MORGAN CARBONELL
Provider Business Mailing Address
First Line : 700 NEXTON SQUARE DR
Second Line :
City : SUMMERVILLE
State : SC
Zip : 29486-7915
Country : US
Telephone Number : 843-879-8577
Fax Number : 843-594-0110
Provider Business Practice Location Address
First Line : 700 NEXTON SQUARE DR
Second Line :
City : SUMMERVILLE
State : SC
Zip : 29486-7915
Country : US
Telephone Number : 843-879-8577
Fax Number : 843-594-0110
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2024
Last Update Date : 07/05/2024

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Directions to “ ERICA MORGAN CARBONELL ” Practice Location

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