Provider Demographics
NPI:1245770858
Name:TROUP, CARLA JEAN
Entity Type:Individual
Prefix:MS
First Name:CARLA
Middle Name:JEAN
Last Name:TROUP
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:CARLA
Other - Middle Name:JEAN
Other - Last Name:TROUP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1307 SW WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73501-7231
Mailing Address - Country:US
Mailing Address - Phone:580-355-7500
Mailing Address - Fax:
Practice Address - Street 1:1307 SW WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73501-7231
Practice Address - Country:US
Practice Address - Phone:580-355-7500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-01
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor