Most Relevant Information
Provider Data
| NPI Number: | 1003181934 |
| Provider Name: | TERESITA NUGUID CARMACK |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/10/2012 |
| Last Updated: | 03/10/2012 |
Provider Practice Location
5512 FOREST RIDGE DR
WINTER HAVEN
FL
338810700
Practice Location Phone/Fax
| Phone: | 7724807641 |
| Fax: |
Provider Mailing Location
5512 FOREST RIDGE DR
WINTER HAVEN
FL
338810700
Provider Mailing Phone/Fax
| Phone: | 7724807641 |
| Fax: |