Provider Demographics
NPI:1447449186
Name:RZASA, CARRIE LYN (BS, CEIS)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:LYN
Last Name:RZASA
Suffix:
Gender:F
Credentials:BS, CEIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 CORDAGE PARK CIR
Mailing Address - Street 2:SUITE 305
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-7331
Mailing Address - Country:US
Mailing Address - Phone:508-830-3444
Mailing Address - Fax:
Practice Address - Street 1:36 CORDAGE PARK CIR
Practice Address - Street 2:SUITE 305
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-7331
Practice Address - Country:US
Practice Address - Phone:508-830-3444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-18
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No101Y00000XBehavioral Health & Social Service ProvidersCounselor