Individual
DR. CAROLYN MOORE NEWBERGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.D.
Contact information
Practice address
92 EVANS RD, BROOKLINE, MA 02445-2118
(161) 756-6693
Mailing address
92 EVANS RD, BROOKLINE, MA 02445-2118
(161) 756-6693
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
2147
MA
103TC0700X
Clinical Psychologist
Primary
2147
MA
103TC2200X
Clinical Child & Adolescent Psychologist
2147
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
70010000W03763
BCBSMA LEGACY NUMBER
MA
Enumeration date
06/22/2009
Last updated
06/22/2009
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