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Individual

PATRICIA ANN CARROLL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTRL

Contact information

Practice address
2080 WOODWINDS DR, #240, WOODBURY, MN 55125-2523
(651) 702-0750
Mailing address
2080 WOODWINDS DR, #240, WOODBURY, MN 55125-2523
(651) 702-0750

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
100349
MN
225X00000X
Occupational Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
797605400
MN
Enumeration date
03/07/2007
Last updated
09/15/2020
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