| NPI | 1447672191 |
|---|---|
| Former Name | KRISTEN MARIE CARROLL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801097655) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 09773) |
| Enumeration Date | 2014-01-15 |
| Last Update Date | 2019-12-06 |