Brackett, Carol Lou

Brackett, Carol Lou is an individual health care provider with primary practice located at 207 B Rock Prairie Rd , College Station TX 77845. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Brackett, Carol Lou can be contacted via phone (979) 690-9301.

Contact Information

Primary practice address
207 B Rock Prairie Rd College Station TX 77845
Phone: (979) 690-9301
Fax: (979) 694-7337
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 3830 Texas

Profile Details

NPI number 1295809952
LBN Legal business name Brackett, Carol Lou
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 17th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295809952 NPPES
Texas MEDICAID 0334S4201

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