Provider Demographics
NPI:1801960612
Name:MAURER, CAROLYN G (PHD)
Entity type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:G
Last Name:MAURER
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 1:555 REPUBLIC DR
Mailing Address - Street 2:STE. 200
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-5481
Mailing Address - Country:US
Mailing Address - Phone:972-867-2145
Mailing Address - Fax:972-516-4207
Practice Address - Street 1:555 REPUBLIC DR
Practice Address - Street 2:STE. 200
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-5481
Practice Address - Country:US
Practice Address - Phone:972-867-2145
Practice Address - Fax:972-516-4207
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2008-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2978101YP2500X
TX821106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist