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Individual

PAMELA CARROLL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
16 DEGRANDPRE WAY, SUITE 200, PLATTSBURGH, NY 12901-6451
(518) 561-6361
Mailing address
71 BRUNELL RD, ALTONA, NY 12910-2402
(518) 204-4112

Taxonomy

Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary

Other

Enumeration date
03/21/2015
Last updated
03/21/2015
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