Provider Demographics
NPI:1447092176
Name:RAYMOND, CAROLINE ELIZABETH (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:ELIZABETH
Last Name:RAYMOND
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 INNERBELT RD APT 633
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-4712
Mailing Address - Country:US
Mailing Address - Phone:978-870-6281
Mailing Address - Fax:
Practice Address - Street 1:100 CUMMINGS CTR STE 135H
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-6127
Practice Address - Country:US
Practice Address - Phone:978-927-0172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-12
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MASLP100734235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist