Provider Demographics
NPI:1588099816
Name:MARVIN, CAROLINE DORNEY (PHD)
Entity type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:DORNEY
Last Name:MARVIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 HARWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:MA
Mailing Address - Zip Code:01460-1625
Mailing Address - Country:US
Mailing Address - Phone:617-899-1290
Mailing Address - Fax:978-339-5335
Practice Address - Street 1:304 HARWOOD AVE
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:MA
Practice Address - Zip Code:01460-1625
Practice Address - Country:US
Practice Address - Phone:617-899-1290
Practice Address - Fax:978-339-5335
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-05
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2220103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical