Provider Demographics
NPI:1992084610
Name:CRAVEN, NICOLE M
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:M
Last Name:CRAVEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 WEBSTER ST
Mailing Address - Street 2:BOX 11
Mailing Address - City:ROCKLAND
Mailing Address - State:MA
Mailing Address - Zip Code:02370-1700
Mailing Address - Country:US
Mailing Address - Phone:781-803-2117
Mailing Address - Fax:
Practice Address - Street 1:28 WEBSTER ST
Practice Address - Street 2:BOX 11
Practice Address - City:ROCKLAND
Practice Address - State:MA
Practice Address - Zip Code:02370-1700
Practice Address - Country:US
Practice Address - Phone:781-803-2117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-11
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist