Healthcare Provider Details

I. General information

NPI: 1952223059
Provider Name (Legal Business Name): TANYA T GARRISON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

383 ELLIOT ST STE 250
NEWTON MA
02464-1126
US

IV. Provider business mailing address

52 RICHMERE RD APT 2
BOSTON MA
02126-3222
US

V. Phone/Fax

Practice location:
  • Phone: 617-964-3332
  • Fax:
Mailing address:
  • Phone: 239-529-8213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT6605
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: