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Individual

ANNETTE CARROLL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
6009 HOWE DR, FAIRWAY, KS 66205-3445
(913) 262-6239
(913) 262-6239
Mailing address
6009 HOWE DR, FAIRWAY, KS 66205-3445
(913) 262-6239
(913) 262-6239

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6127
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100098080A
KS
01
100098080C
SED WAIVER
KS
Enumeration date
03/01/2007
Last updated
03/23/2011
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