Healthcare Provider Details

I. General information

NPI: 1811101868
Provider Name (Legal Business Name): DR. TARA E O'LEARY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 MASSACHUSETTS AVE SUITE 301
ARLINGTON MA
02474-8448
US

IV. Provider business mailing address

180 MASSACHUSETTS AVE SUITE 301
ARLINGTON MA
02474-8448
US

V. Phone/Fax

Practice location:
  • Phone: 781-641-0089
  • Fax:
Mailing address:
  • Phone: 781-641-0089
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number8440
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number8440
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: