Provider Demographics
NPI:1558652891
Name:MASTERS, CARIE MAE (BA)
Entity Type:Individual
Prefix:
First Name:CARIE
Middle Name:MAE
Last Name:MASTERS
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19782 530TH ST
Mailing Address - Street 2:
Mailing Address - City:CHARITON
Mailing Address - State:IA
Mailing Address - Zip Code:50049-8547
Mailing Address - Country:US
Mailing Address - Phone:319-361-6529
Mailing Address - Fax:319-228-8776
Practice Address - Street 1:1711 OSCEOLA AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:CHARITON
Practice Address - State:IA
Practice Address - Zip Code:50049-1516
Practice Address - Country:US
Practice Address - Phone:319-361-6529
Practice Address - Fax:319-228-8776
Is Sole Proprietor?:No
Enumeration Date:2011-04-20
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor