Individual
CARYN WILLA LISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
410 LAFAYETTE ST, SALEM, MA 01970-5347
(508) 662-4464
Mailing address
410 LAFAYETTE ST, SALEM, MA 01970-5347
(508) 662-4464
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
114857
MA
Other
Enumeration date
10/03/2012
Last updated
10/03/2012
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