Individual
INDARA CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5901 ICICLE FALLS AVE, LAS VEGAS, NV 89130-2826
(951) 666-9693
Mailing address
5901 ICICLE FALLS AVE, LAS VEGAS, NV 89130-2826
(951) 666-9693
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
0134000311
VA
106E00000X
Assistant Behavior Analyst
—
NV
Other
Enumeration date
07/09/2020
Last updated
08/18/2021
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