Provider Demographics
NPI:1881471811
Name:CARTER, AMBER LATRICE (LMT,CPT,CRP,C-MLD)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:LATRICE
Last Name:CARTER
Suffix:
Gender:F
Credentials:LMT,CPT,CRP,C-MLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 FOUNTAIN VIEW DR # 1297
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-3206
Mailing Address - Country:US
Mailing Address - Phone:678-515-6593
Mailing Address - Fax:
Practice Address - Street 1:23106 BARRINGTON BLUFF TRL
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77373-2018
Practice Address - Country:US
Practice Address - Phone:678-515-6593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT138794225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty