Individual
MR. TIMOTHY MARTIN CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CAS
Contact information
Practice address
1127 S PATRICK DR, SUITE 24, SATELLITE BEACH, FL 32937-3939
(321) 773-1111
(321) 773-1692
Mailing address
1127 S PATRICK DR, SUITE 24, SATELLITE BEACH, FL 32937-3939
(321) 773-1111
(321) 773-1692
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1205A
FL
Other
Enumeration date
01/25/2010
Last updated
01/25/2010
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