MEDICARE: CARLA M. SMITH PICARIELLO PH.D.

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	103T00000X	Psychologist	6664	MA

General Provider Information

NPI Number	:	1407024193
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLA M. SMITH PICARIELLO PH.D.

Provider Business Mailing Address
First Line	:	7 CENTRAL ST
Second Line	:	SUITE 207
City	:	ARLINGTON
State	:	MA
Zip	:	02476-4800
Country	:	US
Telephone Number	:	781-646-7271
Fax Number	:	978-486-0094

Provider Business Practice Location Address
First Line	:	7 CENTRAL ST
Second Line	:	SUITE 207
City	:	ARLINGTON
State	:	MA
Zip	:	02476-4800
Country	:	US
Telephone Number	:	781-646-7271
Fax Number	:	978-486-0094

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

Provider Enumeration Date	:	02/14/2008
Last Update Date	:	02/14/2008

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