Provider Demographics
NPI:1902995541
Name:THIES, CAROLINE ANNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:ANNE
Last Name:THIES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 LEDYARD RD
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-4039
Mailing Address - Country:US
Mailing Address - Phone:781-729-1101
Mailing Address - Fax:
Practice Address - Street 1:232 GARDEN ST
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492-2321
Practice Address - Country:US
Practice Address - Phone:781-718-1101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7495103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist