Healthcare Provider Details

I. General information

NPI: 1780509125
Provider Name (Legal Business Name): TIFFANY MARIE FERRANT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 FERRY ST
BRADFORD MA
01835-7442
US

IV. Provider business mailing address

48 ELM ST
WORCESTER MA
01609-2541
US

V. Phone/Fax

Practice location:
  • Phone: 351-222-8064
  • Fax:
Mailing address:
  • Phone: 351-222-8064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberS79629736
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: