MEDICARE: JULIE PAINE

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

General Provider Information

NPI Number	:	1063712495
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE PAINE

Provider Business Mailing Address
First Line	:	151 CHIPPER HILL RD
Second Line	:
City	:	NORTHBRIDGE
State	:	MA
Zip	:	01534-1053
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	151 CHIPPER HILL RD
Second Line	:
City	:	NORTHBRIDGE
State	:	MA
Zip	:	01534-1053
Country	:	US
Telephone Number	:	919-749-8592
Fax Number	:

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

Provider Enumeration Date	:	11/02/2010
Last Update Date	:	11/02/2010

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Directions to “ JULIE PAINE ” Practice Location

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