Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003360470 |
---|---|
Provider Name | John Carduff |
First Address | Bridgewater, MA 02324-1733 |
Second Address | Taunton, MA 02780-3469 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2016 |
Last Update Date | 15/08/2016 |