Individual
DAVID CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD, LP
Contact information
Practice address
1751 TOWER DR W STE 200, STILLWATER, MN 55082-7596
(651) 439-2059
(888) 675-8262
Mailing address
588 101ST AVE N, NAPLES, FL 34108-3201
(651) 439-2059
(888) 675-8262
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2633
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205913290
—
MN
Enumeration date
11/01/2006
Last updated
11/05/2020
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