Provider Demographics
NPI:1407169279
Name:SWEENEY, CARINA (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CARINA
Middle Name:
Last Name:SWEENEY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SANDY HILL DR
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02324-1647
Mailing Address - Country:US
Mailing Address - Phone:781-510-0608
Mailing Address - Fax:
Practice Address - Street 1:1 SANDY HILL DR
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02324-1647
Practice Address - Country:US
Practice Address - Phone:781-510-0608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-21
Last Update Date:2023-03-11
Deactivation Date:2023-03-01
Deactivation Code:
Reactivation Date:2023-03-09
Provider Licenses
StateLicense IDTaxonomies
MASPL9421235Z00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program