Individual
IRENE V CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
106280
TX
225XP0200X
Pediatric Occupational Therapist
106280
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005464501
—
TX
01
—
8T0154
BCBS
TX
Enumeration date
12/19/2006
Last updated
04/20/2010
Update your record
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