Provider Demographics
NPI:1255948493
Name:COLORUSSO, CAROLINE M (MS, CF-SLP)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:M
Last Name:COLORUSSO
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 WYOMING AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH READING
Mailing Address - State:MA
Mailing Address - Zip Code:01864-1434
Mailing Address - Country:US
Mailing Address - Phone:978-276-1958
Mailing Address - Fax:
Practice Address - Street 1:7 BALDWIN ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NH
Practice Address - Zip Code:03235-2000
Practice Address - Country:US
Practice Address - Phone:603-934-2541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-30
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHP-0829235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist