Individual
SOPHIA GRACE CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
1035 STRADER DR STE 150, LEXINGTON, KY 40505-4090
(859) 899-9200
Mailing address
1035 STRADER DR STE 150, LEXINGTON, KY 40505-4090
(859) 899-9200
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-294620
KY
Other
Enumeration date
09/25/2023
Last updated
09/25/2023
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