Provider Demographics
NPI:1417447194
Name:CARRASQUILLO, ALEJANDRA (BS)
Entity Type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:
Last Name:CARRASQUILLO
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 PARKRIDGE RD STE 2B
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01835-8515
Mailing Address - Country:US
Mailing Address - Phone:978-606-7387
Mailing Address - Fax:
Practice Address - Street 1:12 METHUEN ST FL 2
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01840-1700
Practice Address - Country:US
Practice Address - Phone:978-606-7387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-17
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker