Individual
KYRA D. CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
901 E 18TH AVE, EUGENE, OR 97403-1354
(541) 346-3575
Mailing address
2285 E 29TH AVE, EUGENE, OR 97403-1836
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12072
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
229148
—
OR
Enumeration date
07/31/2006
Last updated
07/08/2007
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