Provider Demographics
NPI:1578712691
Name:CARAVELLO, MOLLIE DANIELLE (MT-BC)
Entity Type:Individual
Prefix:MRS
First Name:MOLLIE
Middle Name:DANIELLE
Last Name:CARAVELLO
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 VERNON STREET
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062
Mailing Address - Country:US
Mailing Address - Phone:781-718-3960
Mailing Address - Fax:
Practice Address - Street 1:216 VERNON ST
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-2108
Practice Address - Country:US
Practice Address - Phone:781-718-3960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-12
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist