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NPI Code Detail

MEDICARE: KRISTEN RESNICK

MEDICARE: KRISTEN RESNICK
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
11041C0700XClinical Social Worker
21041C0700XClinical Social WorkerMA

General Provider Information

NPI Number : 1891217931
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTEN RESNICK
Provider Business Mailing Address
First Line : 61 INDUSTRIAL PARK RD STE 5
Second Line :
City : PLYMOUTH
State : MA
Zip : 02360-7246
Country : US
Telephone Number : 857-939-5014
Fax Number :
Provider Business Practice Location Address
First Line : 61 INDUSTRIAL PARK RD STE 5
Second Line :
City : PLYMOUTH
State : MA
Zip : 02360-7246
Country : US
Telephone Number : 857-939-5014
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2017
Last Update Date : 09/01/2022

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Directions to “ KRISTEN RESNICK ” Practice Location

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