Provider Demographics
NPI:1407874878
Name:DICARLO, MARGARET ANN (PHD)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:ANN
Last Name:DICARLO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:50 MAUDE ST
Mailing Address - Street 2:ELMHURST 5TH FLOOR
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02908-4325
Mailing Address - Country:US
Mailing Address - Phone:401-456-2479
Mailing Address - Fax:401-456-2399
Practice Address - Street 1:450 VETERANS MEMORIAL PKWY
Practice Address - Street 2:STE 8B
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-5315
Practice Address - Country:US
Practice Address - Phone:401-456-2479
Practice Address - Fax:401-456-2399
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS00679103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist