MEDICARE: TIARA EMONY BUSH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1447103106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIARA EMONY BUSH

Provider Business Mailing Address
First Line	:	20 GOLDTHWAITE RD
Second Line	:
City	:	WORCESTER
State	:	MA
Zip	:	01605-1499
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 GOLDTHWAITE RD
Second Line	:
City	:	WORCESTER
State	:	MA
Zip	:	01605-1499
Country	:	US
Telephone Number	:	508-552-1298
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/20/2026
Last Update Date	:	02/20/2026

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Directions to “ TIARA EMONY BUSH ” Practice Location

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