Provider Demographics
NPI:1972292530
Name:CARROLL, ERIN (CAT-LP)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:
Last Name:CARROLL
Suffix:
Gender:F
Credentials:CAT-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 COOLIDGE PL
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-1306
Mailing Address - Country:US
Mailing Address - Phone:201-615-7796
Mailing Address - Fax:
Practice Address - Street 1:12 COOLIDGE PL
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1306
Practice Address - Country:US
Practice Address - Phone:201-615-7796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-01
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist