Individual
REVITAL CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DOULA, CMT, CEIM
Contact information
Practice address
326 VAN NESS AVE, SANTA CRUZ, CA 95060-3538
(928) 713-7123
Mailing address
326 VAN NESS AVE, SANTA CRUZ, CA 95060-3538
(928) 713-7123
Taxonomy
Speciality
Code
Description
License number
State
102X00000X
Poetry Therapist
—
—
174H00000X
Health Educator
—
—
174N00000X
Lactation Consultant (Non-RN)
—
—
225600000X
Dance Therapist
—
—
225700000X
Massage Therapist
—
—
374J00000X
Doula
Primary
—
—
Other
Enumeration date
05/09/2024
Last updated
05/09/2024
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