NPI 1356566731 · live from the CMS NPI Registry
Wanda Carroll, PTA, LMT, CNA
Physical Therapy Assistant in Severna Park, MD. National Provider Identifier 1356566731, active.
NPI record
| NPI | 1356566731 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physical Therapy Assistant 225200000X |
| Practice location | 839 Cottonwood Dr, Severna Park, MD 21146 |
| Practice phone | 443-986-2959 |
| Enumerated | April 13, 2007 |
| Last updated | June 9, 2015 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Specialist | 174400000X | M00487 (MD) |
| Massage Therapist | 225700000X | M00487 (MD) |
| Physical Therapy Assistant primary | 225200000X | A3443 (MD) |
| Home Health Aide | 374U00000X | A00010416 (MD) |
| Nurse's Aide | 376K00000X | A00010416 (MD) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.