Provider Demographics
NPI:1124409347
Name:CARRASCO, MARTHA A
Entity type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:A
Last Name:CARRASCO
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MARTHA
Other - Middle Name:A
Other - Last Name:GUZMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:119 SWAN ST
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-5324
Mailing Address - Country:US
Mailing Address - Phone:978-258-7076
Mailing Address - Fax:978-620-8230
Practice Address - Street 1:119 SWAN ST
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-5324
Practice Address - Country:US
Practice Address - Phone:978-258-7076
Practice Address - Fax:978-620-8230
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-12
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No171R00000XOther Service ProvidersInterpreter