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Individual

DOREEN MARIE CARROLL

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
MS LMFT

Contact information

Practice address
200 VALENCIA DRIVE, STE #161, JACKSONVILLE, NC 28546
(910) 347-9855
(910) 353-4310
Mailing address
200 VALENCIA DRIVE, STE #161, JACKSONVILLE, NC 28546
(910) 347-9855
(910) 353-4310

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
647
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6105050
NC
Enumeration date
02/13/2006
Last updated
07/08/2007
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