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Individual

MS. BRAE W CARROLL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1071 CARRIAGE HILL RD, MELBOURNE, FL 32940-6418
(321) 720-5083
Mailing address
1071 CARRIAGE HILL RD, MELBOURNE, FL 32940-6418
(321) 720-5083

Taxonomy

Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary

Other

Enumeration date
12/05/2009
Last updated
12/05/2009
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