Provider Demographics
NPI:1558434449
Name:CARROLL, DAVID ORRY (QMHW)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ORRY
Last Name:CARROLL
Suffix:
Gender:M
Credentials:QMHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1529 EDIE CT
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-4810
Mailing Address - Country:US
Mailing Address - Phone:805-922-0922
Mailing Address - Fax:
Practice Address - Street 1:1529 EDIE CT
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-4810
Practice Address - Country:US
Practice Address - Phone:805-922-0922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor