Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | ||
N | 101YP1600X | Pastoral Counselor | ||
N | 104100000X | Social Worker |
NPI | 1184248536 |
---|---|
Provider Name | Mrs. Sherill Angelee Carpenter |
First Address | Woodbridge, VA 22191-6520 |
Second Address | Woodbridge, VA 22191-6520 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2020 |
Last Update Date | 02/06/2020 |