Individual
SHELIA GAYE CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
104 JV MANGUBAT DR, WAYNESBORO, TN 38485-2439
(931) 722-3641
Mailing address
60 HAWTHORNE DR, LAWRENCEBURG, TN 38464-7039
(931) 477-0311
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3256
TN
224Z00000X
Occupational Therapy Assistant
5057
AL
Other
Enumeration date
07/08/2019
Last updated
07/08/2019
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