Provider Demographics
NPI:1992397913
Name:CARRO, ALYSSA MAY
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:MAY
Last Name:CARRO
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 1:5 STRATFORD RD
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-4213
Mailing Address - Country:US
Mailing Address - Phone:781-366-4210
Mailing Address - Fax:
Practice Address - Street 1:5 STRATFORD RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021-4213
Practice Address - Country:US
Practice Address - Phone:781-366-4210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-10
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALABA10000573103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst