Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003114349 |
---|---|
Provider Name | Daniel Ryan Carter |
First Address | Valparaiso, IN 46383-3138 |
Second Address | Valparaiso, IN 46383-3138 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2011 |
Last Update Date | 17/07/2013 |