Provider Demographics
NPI:1700038387
Name:VESPIA, CAROL (MASTERS)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:VESPIA
Suffix:
Gender:F
Credentials:MASTERS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 SPENCER CT
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02879-2820
Mailing Address - Country:US
Mailing Address - Phone:401-782-8940
Mailing Address - Fax:401-782-1145
Practice Address - Street 1:81 SPENCER CT
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:RI
Practice Address - Zip Code:02879-2820
Practice Address - Country:US
Practice Address - Phone:401-782-8940
Practice Address - Fax:401-782-1145
Is Sole Proprietor?:No
Enumeration Date:2008-10-15
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIGH57134Medicaid