Provider Demographics
NPI:1760825459
Name:BRINKERT, CAROLINE J (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:CAROLINE
Middle Name:J
Last Name:BRINKERT
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:J
Other - Last Name:DAVIT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:161 S HUNTINGTON AVE
Mailing Address - Street 2:#420
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02130-4823
Mailing Address - Country:US
Mailing Address - Phone:617-852-0016
Mailing Address - Fax:
Practice Address - Street 1:340 TURNPIKE ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021-2700
Practice Address - Country:US
Practice Address - Phone:781-619-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-11
Last Update Date:2016-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8833235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist