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NPI Code Detail

MEDICARE: CARLA BURLEY

MEDICARE:   CARLA  BURLEY
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
1103TS0200XSchool Psychologist454179MA

General Provider Information

NPI Number : 1619609500
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLA BURLEY
Provider Business Mailing Address
First Line : 100 ZACHARY LN
Second Line :
City : ATTLEBORO
State : MA
Zip : 02703-6856
Country : US
Telephone Number : 508-530-8866
Fax Number :
Provider Business Practice Location Address
First Line : 100 ZACHARY LN
Second Line :
City : ATTLEBORO
State : MA
Zip : 02703-6856
Country : US
Telephone Number : 508-530-8866
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2022
Last Update Date : 06/29/2022

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Directions to “ CARLA BURLEY ” Practice Location

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