Individual
ANASTASIA CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103-9000
(800) 926-8273
Mailing address
PO BOX 232410, SAN DIEGO, CA 92193-2410
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
101587
TX
235Z00000X
Speech-Language Pathologist
Primary
20223
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111408402
—
TX
Enumeration date
07/30/2008
Last updated
04/29/2021
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