Individual
DR. CAROLYN GRACE PEABODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D., L.C.S.W.
Contact information
Practice address
53840 MAIN RD, SOUTHOLD, NY 11971-4625
(631) 323-1333
(631) 323-3824
Mailing address
970 GREENWAY E, ORIENT, NY 11957-1314
(631) 323-1333
(631) 323-3824
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
R038969-1
NY
Other
Enumeration date
07/19/2008
Last updated
07/19/2008
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