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General NPI Number Information
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NPI Number | 1578198172
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Entity Type | Individual
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Provider Name | KATHRYN MARIE CARUSO
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Gender | Female
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Dates
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Enumeration Date | 03/04/2020
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Last Update Date | 03/04/2020
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Provider Practice Location Address
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Address Line | 400 WASHINGTON ST STE 106
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City | BRAINTREE
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State | MA
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Zip | 02184-4764
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Country | US
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Telephone | 781-817-6386
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Fax | 781-817-6427
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Provider Business Mailing Address
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Address Line | 400 WASHINGTON ST STE 106
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City | BRAINTREE
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State | MA
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Zip | 02184-4764
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Country | US
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Telephone | 781-817-6386
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Fax | 781-817-6427
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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