MEDICARE: COURTNEY GARRAHAN

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	103K00000X	Behavior Analyst	LABA10001422	MA
2	222Q00000X	Developmental Therapist

General Provider Information

NPI Number	:	1710545694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURTNEY GARRAHAN

Provider Business Mailing Address
First Line	:	43 BROAD ST STE C300
Second Line	:
City	:	HUDSON
State	:	MA
Zip	:	01749-2558
Country	:	US
Telephone Number	:	508-651-7500
Fax Number	:

Provider Business Practice Location Address
First Line	:	43 BROAD ST STE C300
Second Line	:
City	:	HUDSON
State	:	MA
Zip	:	01749-2558
Country	:	US
Telephone Number	:	508-651-7500
Fax Number	:

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

Provider Enumeration Date	:	06/05/2019
Last Update Date	:	07/28/2025

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