Provider Demographics
NPI:1033993548
Name:CARPENTER, KARLI ALIYA (MA)
Entity Type:Individual
Prefix:
First Name:KARLI
Middle Name:ALIYA
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21005 DUNDEE DR
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-4741
Mailing Address - Country:US
Mailing Address - Phone:248-756-9317
Mailing Address - Fax:
Practice Address - Street 1:1085 S LINDEN RD STE 150
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3430
Practice Address - Country:US
Practice Address - Phone:810-262-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6362009818103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical