NPI | 1962021212 |
---|---|
Other Name | TED L CARROLL |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WA MG60947452) |
Additional Taxonomies | 101Y00000X Counselor (Licence: WA LH61050462) |
Enumeration Date | 2020-04-15 |
Last Update Date | 2023-11-16 |