| Doctor Name: | MRS. CAROLYN PHYLLIS ANDERSON |
| NPI Number: | 1043300379 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A. |
| License Number: | |
| Business Practice Address: | 288 Bedford St Whitman, MA - 023821820 |
| Business Phone Number: | 7814476425 |
| Business Fax Number: | 7814471786 |
| Mailing Address: | 29 Newton St, BROCKTON |
| State: | MA |
| Postal Code: | 023015114 |
| Phone Number: | 5085623883 |
| Fax Number: | |
| NPI Enumeration Date: | 10/16/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |