Provider Demographics
NPI:1609767763
Name:CARROLL, NILSA (MT-BC)
Entity type:Individual
Prefix:
First Name:NILSA
Middle Name:
Last Name:CARROLL
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 WALNUT RD UNIT 1
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34480-4475
Mailing Address - Country:US
Mailing Address - Phone:972-336-3436
Mailing Address - Fax:
Practice Address - Street 1:2605 NE 3RD ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-7045
Practice Address - Country:US
Practice Address - Phone:972-336-3436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-15
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
13716225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist