Individual
ANDREA CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
54 JOANNE DR, HOLBROOK, NY 11741-5603
(631) 561-8309
Mailing address
54 JOANNE DR, HOLBROOK, NY 11741-5603
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
002868
NY
Other
Enumeration date
03/20/2024
Last updated
08/05/2025
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