Provider Demographics
NPI:1790983260
Name:CARPER, MARLENE S (PHD)
Entity Type:Individual
Prefix:
First Name:MARLENE
Middle Name:S
Last Name:CARPER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3218 TREASURE HILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-7800
Mailing Address - Country:US
Mailing Address - Phone:956-245-4187
Mailing Address - Fax:
Practice Address - Street 1:2529 W TRENTON RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-5070
Practice Address - Country:US
Practice Address - Phone:956-994-3880
Practice Address - Fax:956-994-3877
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12675103TC0700X
TX6129103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool