Provider Demographics
NPI:1821472754
Name:CARROLL, SARAH ELAINE
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:ELAINE
Last Name:CARROLL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1708 UNIVERSITY BLVD
Mailing Address - Street 2:APT 4
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46012-3100
Mailing Address - Country:US
Mailing Address - Phone:937-564-5413
Mailing Address - Fax:
Practice Address - Street 1:1708 UNIVERSITY BLVD
Practice Address - Street 2:APT 4
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46012-3100
Practice Address - Country:US
Practice Address - Phone:937-564-5413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-09
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer