Provider Demographics
NPI:1467603985
Name:CARROLL, ALLISON T (MS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:T
Last Name:CARROLL
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W COOPER AVE
Mailing Address - Street 2:
Mailing Address - City:WEST MEMPHIS
Mailing Address - State:AR
Mailing Address - Zip Code:72301-3918
Mailing Address - Country:US
Mailing Address - Phone:901-240-9848
Mailing Address - Fax:
Practice Address - Street 1:207 BALFOUR RD
Practice Address - Street 2:
Practice Address - City:WEST MEMPHIS
Practice Address - State:AR
Practice Address - Zip Code:72301-1701
Practice Address - Country:US
Practice Address - Phone:870-733-9950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-02
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR1468225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics