Basic Information
| Provider Information | |||||||||
| NPI: | 1952709347 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CARTER | ||||||||
| FirstName: | ARETHA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 RIVER PLACE DR | ||||||||
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| City: | DETROIT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482074274 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3138712337 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4044 GLENBURNE BLVD | ||||||||
| Address2: | |||||||||
| City: | LANSING | ||||||||
| State: | MI | ||||||||
| PostalCode: | 489112535 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5179800163 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/17/2014 | ||||||||
| LastUpdateDate: | 12/17/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 6802087668 | MI | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.