Provider Demographics
NPI:1760254171
Name:KINDRED, CAROLYN LAURA
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:LAURA
Last Name:KINDRED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:LAURA
Other - Last Name:CUTTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:517 DEERPATH DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28311-1231
Mailing Address - Country:US
Mailing Address - Phone:910-574-3297
Mailing Address - Fax:
Practice Address - Street 1:517 DEERPATH DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28311-1231
Practice Address - Country:US
Practice Address - Phone:910-574-3297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health