Individual
PATRICIA CHRISTINE CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS OTR/L
Contact information
Practice address
3292 EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9580
(616) 365-8920
Mailing address
3292 EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9580
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201008607
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5201008607
STATE OF MICHIGAN
MI
Enumeration date
09/04/2013
Last updated
03/24/2016
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