Individual
KIERSTEN R CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3721 GOLDENROD AVE, PONCA CITY, OK 74604-4602
(580) 491-2442
Mailing address
3721 GOLDENROD AVE, PONCA CITY, OK 74604-4602
(580) 491-2442
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
—
—
Other
Enumeration date
10/31/2023
Last updated
11/02/2023
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