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NPI Code Detail

MEDICARE: KARISSA LYNNE CARBONNEAU

MEDICARE: KARISSA LYNNE CARBONNEAU
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
1104100000XSocial Worker

General Provider Information

NPI Number : 1972957348
Entity Type Code : Individual
Provider Name (Legal Business Name) : KARISSA LYNNE CARBONNEAU
Provider Business Mailing Address
First Line : 78 MAIN ST
Second Line :
City : WARE
State : MA
Zip : 01082-1318
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 78 MAIN ST
Second Line :
City : WARE
State : MA
Zip : 01082-1318
Country : US
Telephone Number : 413-564-9980
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2016
Last Update Date : 04/21/2016

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Directions to “ KARISSA LYNNE CARBONNEAU ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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