Michaela Lane Carroll, PLPC
Counselor, Professional in Lebanon, MO. Individual provider (NPI-1).
NPI number1720129067
StatusActive
Last updated in NPPESSep 25, 2018
Details
- NPI
- 1720129067
- Entity type
- Individual (NPI-1)
- Name
- Michaela Lane Carroll
- Credential
- PLPC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 9, 2007
- Last updated
- Sep 25, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 2014015461 | MO | Yes |
Practice location
860 Lynn StLebanon, MO 65536-3810
Phone 888-403-1071
Mailing address
1800 CommunityClinton, MO 64735-8804
Phone 660-885-8131
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