Most Relevant Information
Provider Data
| NPI Number: | 1003552449 |
| Provider Name: | SHELLY DIANE CARROLL SLP-ASSISTANT |
| Entity Type: | Individual |
| Taxonomy Code: | 2355S0801X |
| Specialty: | Specialist/Technologist |
| License Number: | 32758 |
Most Important Dates
| Enumeration Date: | 05/09/2022 |
| Last Updated: | 05/09/2022 |
Provider Practice Location
605 E BROAD ST
MANSFIELD
TX
760631794
Practice Location Phone/Fax
| Phone: | 8172996300 |
| Fax: |
Provider Mailing Location
909 MASQUERADE DR
MIDLOTHIAN
TX
760658882
Provider Mailing Phone/Fax
| Phone: | 8176583990 |
| Fax: |