Provider Demographics
NPI:1871905877
Name:POPLIN, CARRIE (MS)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:POPLIN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 BRANDEIS AVE
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-3901
Mailing Address - Country:US
Mailing Address - Phone:850-774-6651
Mailing Address - Fax:
Practice Address - Street 1:807 BRANDEIS AVE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-3901
Practice Address - Country:US
Practice Address - Phone:850-774-6651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-24
Last Update Date:2014-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health