Individual
DR. JOHN MARK CARPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ED.D.
Contact information
Practice address
115 SUMMIT AVE, NO. 3, WINTHROP, MA 02152-1087
(617) 846-5383
(617) 846-1650
Mailing address
115 SUMMIT AVE, NO. 3, WINTHROP, MA 02152-1087
(617) 846-5383
(617) 846-1650
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
3856
MA
103TC0700X
Clinical Psychologist
Primary
3856
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0516678
—
MA
01
—
3856
LIC.. (PSYCHOL.PROVIDER)
MA
Enumeration date
02/09/2007
Last updated
11/29/2011
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