| Doctor Name: | MRS. MARY THERESA CARPENTER |
| NPI Number: | 1003954587 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LSW, MA , MA |
| License Number: | 310405 |
| Business Practice Address: | 250 Commercial St Worcester, MA - 016081726 |
| Business Phone Number: | 5087524665 |
| Business Fax Number: | 5087520947 |
| Mailing Address: | 148 Fairhaven Rd, WORCESTER |
| State: | MA |
| Postal Code: | 016063140 |
| Phone Number: | 5087359555 |
| Fax Number: | |
| NPI Enumeration Date: | 02/05/2007 |
| NPI Last Update Date: | 06/27/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 310405 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |