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Individual

MRS. HARRIETT CARROLL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, CADC

Contact information

Practice address
204 W HIGHLAND AVE, ROBINSON, IL 62454-1710
(618) 546-1021
(618) 544-3791
Mailing address
PO BOX M, 504 MICAH DRIVE, OLNEY, IL 62450-0913
(618) 395-4306
(618) 395-4507

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
10/04/2007
Last updated
11/06/2007
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