Provider Demographics
NPI:1720784515
Name:CARLSON, TARYN (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:TARYN
Middle Name:
Last Name:CARLSON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 MASSACHUSETTS AVE APT 16
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-8319
Mailing Address - Country:US
Mailing Address - Phone:508-887-3658
Mailing Address - Fax:
Practice Address - Street 1:848 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-4815
Practice Address - Country:US
Practice Address - Phone:508-879-5110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-02
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA76974235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist