Healthcare Provider Details

I. General information

NPI: 1477458420
Provider Name (Legal Business Name): CORINOVA SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 WINSLOW ST
GARDNER MA
01440-1914
US

IV. Provider business mailing address

22 WINSLOW ST
GARDNER MA
01440-1914
US

V. Phone/Fax

Practice location:
  • Phone: 774-535-9080
  • Fax:
Mailing address:
  • Phone: 774-535-9080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name: TANAKA MARARIKE
Title or Position: CLINICAL DIRECTOR
Credential: M.S., BCBA, LABA
Phone: 774-535-9080