Provider Demographics
NPI:1407025927
Name:CARR, DABNEY S (LIC AC)
Entity Type:Individual
Prefix:
First Name:DABNEY
Middle Name:S
Last Name:CARR
Suffix:
Gender:F
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 GIFFORD ST
Mailing Address - Street 2:#11
Mailing Address - City:FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02540-2918
Mailing Address - Country:US
Mailing Address - Phone:508-548-8333
Mailing Address - Fax:
Practice Address - Street 1:350 GIFFORD ST
Practice Address - Street 2:#11
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540-2918
Practice Address - Country:US
Practice Address - Phone:508-548-8333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-28
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA456171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist