Doctor Name: | ANNETTE CARROLL |
NPI Number: | 1629106760 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMSW |
License Number: | 6127 |
Business Practice Address: | 6009 Howe Dr Fairway, KS - 662053445 |
Business Phone Number: | 9132626239 |
Business Fax Number: | 9132626239 |
Mailing Address: | 6009 Howe Dr, FAIRWAY |
State: | KS |
Postal Code: | 662053445 |
Phone Number: | 9132626239 |
Fax Number: | 9132626239 |
NPI Enumeration Date: | 03/01/2007 |
NPI Last Update Date: | 03/23/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 6127 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KS |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |