Individual
KYLENE CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
933 CEDAR ROAD, CHESAPEAKE, VA 23322
(757) 941-4119
Mailing address
933 CEDAR RD, CHESAPEAKE, VA 23322-7415
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119004434
VA
Other
Enumeration date
05/21/2008
Last updated
09/02/2016
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