Provider Demographics
NPI:1629388905
Name:CARBONE, MEGHAN CHRISTINA
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:CHRISTINA
Last Name:CARBONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 QUINT AVE
Mailing Address - Street 2:APT 7
Mailing Address - City:ALLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02134-2504
Mailing Address - Country:US
Mailing Address - Phone:781-974-8565
Mailing Address - Fax:
Practice Address - Street 1:460 TOTTEN POND RD
Practice Address - Street 2:SUITE 300
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-1991
Practice Address - Country:US
Practice Address - Phone:781-895-3200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-20
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst