Individual
MS. GRACE NICOLE CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
8224 MENTOR AVE STE 114, MENTOR, OH 44060-5743
(330) 867-2240
Mailing address
7120 BUNKER CV, MENTOR, OH 44060-5333
(440) 710-4258
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA007882
OH
Other
Enumeration date
04/04/2023
Last updated
04/04/2023
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