Individual
TAMMY CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3801 LAKE CT, TRENTON, IL 62293-2938
(573) 382-0732
Mailing address
3801 LAKE CT, TRENTON, IL 62293-2938
(573) 382-0732
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
0486259
MO
Other
Enumeration date
07/03/2020
Last updated
07/03/2020
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