Provider Demographics
NPI:1669580551
Name:LOVELL, CAROLYN MILLS (CGC)
Entity type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:MILLS
Last Name:LOVELL
Suffix:
Gender:F
Credentials:CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 15TH ST.
Mailing Address - Street 2:BG 1071
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30912-3720
Mailing Address - Country:US
Mailing Address - Phone:706-721-2809
Mailing Address - Fax:706-721-5697
Practice Address - Street 1:1120 15TH ST.
Practice Address - Street 2:BG 1071
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30912-3720
Practice Address - Country:US
Practice Address - Phone:706-721-2809
Practice Address - Fax:706-721-5697
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS