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Individual

REBECCA MAE GOAL CARROLL

Active
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Individual

REBECCA MAE GOAL CARROLL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
032288
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02052091
MEDICAID GRP
NY
01
1710923222
GRP NPI
01
AA0171
MCR GROUP
01
AA0172
MCR GROUP
05
PENDING
NY
Enumeration date
01/12/2010
Last updated
08/06/2018
About Stedi
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