Healthcare Provider Details

I. General information

NPI: 1881262723
Provider Name (Legal Business Name): LISA MARIE ESCHENBACH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2021
Last Update Date: 06/16/2021
Certification Date: 06/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1881 WORCESTER RD
FRAMINGHAM MA
01701-5410
US

IV. Provider business mailing address

261 BEECH ST
BELMONT MA
02478-2403
US

V. Phone/Fax

Practice location:
  • Phone: 508-661-2020
  • Fax:
Mailing address:
  • Phone: 617-817-3931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: