Healthcare Provider Details

I. General information

NPI: 1356313621
Provider Name (Legal Business Name): CAROL ANN PERLMAN PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CAROL ANN WIRETT PHD

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 MAIN ST UNIT 203
MEDWAY MA
02053-1584
US

IV. Provider business mailing address

165 MAIN ST UNIT 203
MEDWAY MA
02053-1584
US

V. Phone/Fax

Practice location:
  • Phone: 508-533-3530
  • Fax: 774-324-3002
Mailing address:
  • Phone: 508-533-3530
  • Fax: 774-324-3002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number7932
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: