Carolyn Spungin
Individual provider Active NPI Developmental Therapist · West Roxbury, MA
NPI 1740460435 · NPPES record last updated Nov 9, 2007
Key facts
- NPI
- 1740460435
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Developmental Therapist 222Q00000X
- Practice address
- 25 Willow St
West Roxbury, MA 02132-1537 - Phone
- (617) 469-3080
- NPI assigned
- Nov 9, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Criterion Child Enrichment, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | Yes |
Addresses
Primary practice location
25 Willow St
West Roxbury, MA 02132-1537
Mailing address
25 Willow St
West Roxbury, MA 02132-1537
Phone (617) 469-3080
Other providers in West Roxbury, MA
- William H Southwick
- Nicole Sparages
- Joshua Thomas Spencer
- Merry Elizabeth Spradling
- Robert S Sprague
- Venkatesh Srinivasa
- Claire Stauffer
- Christina Stavrakas
- Hannah Steere
- Stephen V McLaughlin DMD
All providers in West Roxbury, MA · Developmental Therapist in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.