Individual
SHELLEY LYNN CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
349 GREGORY AVE, WEST ORANGE, NJ 07052-3704
(973) 325-1255
Mailing address
349 GREGORY AVE, WEST ORANGE, NJ 07052-3704
(973) 325-1255
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
2504
NJ
103TC0700X
Clinical Psychologist
Primary
2504
NJ
Other
Enumeration date
03/13/2012
Last updated
03/13/2012
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