Individual
MS. VICKI LYNN CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
612 SE JACKSON ST STE 11, ROSEBURG, OR 97470-4956
(541) 464-6455
Mailing address
711 PONDEROSA DR, ROSEBURG, OR 97470-8922
(541) 673-5324
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/29/2007
Last updated
07/08/2007
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