Joshua Carroll
Individual provider Active NPI Day Training/Habilitation Specialist · Wittmann, AZ
NPI 1548314693 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1548314693
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Day Training/Habilitation Specialist 373H00000X
- License
- 10624 (AZ)
- Practice address
- 28523 N 221St Ave
Wittmann, AZ 85361-9784 - Phone
- (602) 738-8788
- NPI assigned
- Jan 23, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10624 | AZ | MD | Day Training/Habilitation Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Day Training/Habilitation Specialist | 373H00000X | 10624 | AZ | Yes |
Addresses
Primary practice location
28523 N 221St Ave
Wittmann, AZ 85361-9784
Mailing address
28523 N 221St Ave
Wittmann, AZ 85361-9784
Phone (602) 738-8788
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 976631 | Medicaid | AZ |
Other providers in Wittmann, AZ
- Kathleen Pospisil Brady
- Michael Raymond Brady
- Margaret Burk
- Dana Marie Cannella
- Virginia H. Carlson
- Billie Church
- Community Hospital Association, Inc.
- Bridgette Curry Medina
- Devoted Transformations LLC
- Elizabeth Marie Dicola
All providers in Wittmann, AZ · Day Training/Habilitation Specialist in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.