Individual
MRS. DESLYN NICOLE CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
3505 OLD JACKSONVILLE RD, TYLER, TX 75701-8510
(903) 561-2011
Mailing address
3505 OLD JACKSONVILLE RD, TYLER, TX 75701-8510
(903) 561-2011
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
209842
TX
Other
Enumeration date
10/01/2007
Last updated
10/01/2007
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