Individual
KATHLEEN A CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS,CCC-SLP
Contact information
Practice address
17100 E SHEA BLVD STE 600, FOUNTAIN HILLS, AZ 85268
(480) 837-4565
Mailing address
7127 W WOOD ST, PHOENIX, AZ 85043-1590
(352) 359-2945
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
SA14492
FL
235Z00000X
Speech-Language Pathologist
Primary
SLP7810
AZ
235Z00000X
Speech-Language Pathologist
TSLP7810
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
709378
—
AZ
Enumeration date
06/18/2012
Last updated
10/03/2018
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