Healthcare Provider Details

I. General information

NPI: 1982594123
Provider Name (Legal Business Name): LORENA OCHOA-MORALES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2025
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 WALNUT ST
MALDEN MA
02148-7028
US

IV. Provider business mailing address

17 WALNUT ST
MALDEN MA
02148-7028
US

V. Phone/Fax

Practice location:
  • Phone: 617-750-3128
  • Fax: 781-321-2022
Mailing address:
  • Phone: 617-750-3128
  • Fax: 781-321-2022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number18658-MT-MT
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: