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Individual
TEENA ELIZABETH CARROLL
Active
Individual
TEENA ELIZABETH CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PTA20577
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA20577
FLORIDA LICENSE
FL
Enumeration date
08/05/2006
Last updated
09/08/2008
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