Provider Demographics
NPI:1063821304
Name:CARTER, ANGELIA (BS/SC, QMRP)
Entity type:Individual
Prefix:MRS
First Name:ANGELIA
Middle Name:
Last Name:CARTER
Suffix:
Gender:F
Credentials:BS/SC, QMRP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 W. FIFTH AVE.
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503
Mailing Address - Country:US
Mailing Address - Phone:810-496-5408
Mailing Address - Fax:810-257-3795
Practice Address - Street 1:420 W. FIFTH AVE.
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503
Practice Address - Country:US
Practice Address - Phone:810-496-5408
Practice Address - Fax:810-257-3795
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-12
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker