Provider Demographics
NPI:1033660212
Name:DALE, CAROLINE (MSED)
Entity Type:Individual
Prefix:MS
First Name:CAROLINE
Middle Name:
Last Name:DALE
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:MRS
Other - First Name:CAROLINE
Other - Middle Name:
Other - Last Name:SAYIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:36 ARNOLD ST
Mailing Address - Street 2:UNIT 2
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-1035
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:463 SWANSEA MALL DR
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:MA
Practice Address - Zip Code:02777-4119
Practice Address - Country:US
Practice Address - Phone:617-694-9796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-21
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program