Individual
MRS. SHELLY DIANE CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP-ASSISTANT
Contact information
Practice address
605 E BROAD ST, MANSFIELD, TX 76063-1794
(817) 299-6300
Mailing address
909 MASQUERADE DR, MIDLOTHIAN, TX 76065-8882
(817) 658-3990
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
32758
TX
Other
Enumeration date
05/09/2022
Last updated
05/09/2022
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