Individual
MISS CRISTA MARY CAVICCHIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
366 SOMERVILLE AVE, SOMERVILLE, MA 02143-2919
(617) 628-8815
Mailing address
21 NEWBURY ST # 2, SOMERVILLE, MA 02144-2442
(617) 823-8668
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
213669
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
213669
LCSW
MA
Enumeration date
05/12/2008
Last updated
05/12/2008
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