| NPI | 1417098971 |
|---|---|
| Former Name | KELLY NICOLE CARROLL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: VA 2201001692) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: CA AU 2286) |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: VA 2101002412) | |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2019-12-19 |