Individual
KOREN CARBUCCIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25 MAPLE ST, PAWTUCKET, RI 02860-2104
(401) 290-8076
Mailing address
25 MAPLE ST, PAWTUCKET, RI 02860-2104
(401) 290-8076
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
200800
—
175T00000X
Peer Specialist
200800
RI
374J00000X
Doula
—
—
Other
Enumeration date
08/03/2020
Last updated
09/13/2022
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