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CHRISSIE NOELLE CARROLL DT

>> Developmental Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1649776295

Individual Registrant:
 CHRISSIE NOELLE CARROLL DT
Gender: F
Sole Proprietor

Location and contact information for practice:
299 SWAN AVE  CENTRALIA, IL 62801-6127 US
Tel: 618-533-4423  Fax: --

Contact information for business:
4920 CROSS RD  SALEM, IL 62881-7002 US
Tel: 618-315-5492  Fax: --

Registration Information:
NPI: 1649776295
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Developmental Therapist
IL

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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