MEDICARE: LORYN TRAVERSI-IRWIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	120470	MA

General Provider Information

NPI Number	:	1053818690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORYN TRAVERSI-IRWIN

Provider Business Mailing Address
First Line	:	15 PLACID BAY DR
Second Line	:
City	:	PLYMOUTH
State	:	MA
Zip	:	02360-7119
Country	:	US
Telephone Number	:	978-697-7730
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 ARMSTRONG RD
Second Line	:
City	:	PLYMOUTH
State	:	MA
Zip	:	02360-7219
Country	:	US
Telephone Number	:	508-209-4438
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2018
Last Update Date	:	04/10/2018

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Directions to “ LORYN TRAVERSI-IRWIN ” Practice Location

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