Individual
CAMMY CHICOTA-CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3551 ROGER BROOKE DR, JBSA FT SAM HOUSTON, TX 78234-4504
(210) 916-7641
Mailing address
3339 FALLING BRK STE 104, SAN ANTONIO, TX 78258-4432
(719) 650-9967
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PY00003655
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37844
LICENSE
TX
Enumeration date
01/03/2007
Last updated
03/04/2024
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