Individual
KAITLYN SAMANTHA CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
560 SPRINGFIELD AVE, WESTFIELD, NJ 07090-1024
(908) 232-0100
(908) 935-0515
Mailing address
PO BOX 2458, WESTFIELD, NJ 07091-2458
(908) 232-0100
(908) 935-0515
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/21/2019
Last updated
10/21/2019
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