Healthcare Provider Details

I. General information

NPI: 1316379563
Provider Name (Legal Business Name): AYER INTEGRATIVE THERAPIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2013
Last Update Date: 07/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 EAST ST
AYER MA
01432-1805
US

IV. Provider business mailing address

10 EAST ST
AYER MA
01432-1805
US

V. Phone/Fax

Practice location:
  • Phone: 978-480-0003
  • Fax:
Mailing address:
  • Phone: 978-480-0003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: GWYN M CATTELL
Title or Position: PARTNER
Credential: MD
Phone: 978-480-0003