Individual
HEIDI CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8328 OLMSTEAD PL SE, SNOQUALMIE, WA 98065-1344
(425) 525-8125
Mailing address
8328 OLMSTEAD PL SE, SNOQUALMIE, WA 98065-1344
(425) 525-8125
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
CAAR.CG.60752021
WA
Other
Enumeration date
04/14/2017
Last updated
04/14/2017
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