Individual
JENNIFER CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
801 S WOODLAWN AVE, O FALLON, MO 63366-7646
(636) 379-1779
Mailing address
801 S WOODLAWN AVE, O FALLON, MO 63366-7646
(636) 379-1779
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
MO
Other
Enumeration date
04/18/2023
Last updated
01/14/2026
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