Individual
JOSHUA CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
28523 N 221ST AVE, WITTMANN, AZ 85361-9784
(602) 738-8788
Mailing address
28523 N 221ST AVE, WITTMANN, AZ 85361-9784
(602) 738-8788
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
10624
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
976631
—
AZ
Enumeration date
01/23/2007
Last updated
07/09/2007
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