| Doctor Name: | MRS. KIMBERLY A CARROLL |
| NPI Number: | 1104039080 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | BA |
| License Number: | |
| Business Practice Address: | 570 Lee St Perth Amboy, NJ - 088613053 |
| Business Phone Number: | 7323766700 |
| Business Fax Number: | |
| Mailing Address: | 108 Hagaman St, CARTERET |
| State: | NJ |
| Postal Code: | 070082033 |
| Phone Number: | 7329699695 |
| Fax Number: | |
| NPI Enumeration Date: | 05/08/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |