Provider Information for 1487056693
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ROBERT WILLIAM CARROLL LCSW
Sex: Male
NPI: 1487056693
Last Updated: 2024-12-12
Certification Date: 2024-12-12
Certification Date: 2024-12-12
Details
| Name | Value | ||||||||||||
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| NPI | 1487056693 | ||||||||||||
| Enumeration Date | 2014-09-18 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 201 MAIN ST STE 500 LA CROSSE, WI 54601-0716 United States Phone: 608-668-4005 | Fax: | ||||||||||||
| Primary Practice Address | 201 MAIN ST STE 500 LA CROSSE, WI 54601-0716 United States Phone: 608-668-4005 | Fax: | ||||||||||||
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