Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XM0800X | Mental Health | 6112 | MA |
NPI | 1659913986 |
---|---|
Provider Name | Rosanna M Casavecchia |
First Address | Groton, MA 01450-4214 |
Second Address | Norwell, MA 02061-2010 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/10/2019 |
Last Update Date | 08/10/2019 |