Individual
TERESA MARIE CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSAC-A AND CSAC-S
Contact information
Practice address
1258 HOLLAND RD, SUFFOLK, VA 23434-6313
(800) 805-6989
Mailing address
1258 HOLLAND RD, SUFFOLK, VA 23434-6313
(800) 805-6989
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0711000550
VA
Other
Enumeration date
07/05/2022
Last updated
07/07/2022
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