Individual
ANDREW MABON CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
713 HARRISON ST, SYRACUSE, NY 13210-2305
(315) 464-3145
Mailing address
919 E GENESEE ST, SYRACUSE, NY 13210-1739
(610) 680-7259
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
P124005
NY
Other
Enumeration date
08/29/2023
Last updated
08/29/2023
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