Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | FL |
NPI | 1003193913 |
---|---|
Provider Name | Carrie M Houseman |
First Address | Kissimmee, FL 34744-2708 |
Second Address | Kissimmee, FL 34744-2708 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2011 |
Last Update Date | 05/11/2011 |