Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | OH | |
N | 101YS0200X | School Counselor | OH |
NPI | 1295490761 |
---|---|
Provider Name | Dr. Mecca S. Carter-Marshall |
First Address | Springfield, OH 45502-8421 |
Second Address | Springfield, OH 45502-8421 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2021 |
Last Update Date | 01/11/2021 |