| NPI | 1073465076 |
|---|---|
| Other Name | BLAKE CARROLL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2026-02-11 |
| Last Update Date | 2026-02-11 |