Healthcare Provider Details

I. General information

NPI: 1023760048
Provider Name (Legal Business Name): TIRZA ESPINAL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2022
Last Update Date: 01/20/2022
Certification Date: 01/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 BOSTON ST
SALEM MA
01970-1402
US

IV. Provider business mailing address

1000 LORING AVE APT A114
SALEM MA
01970-4260
US

V. Phone/Fax

Practice location:
  • Phone: 978-223-8233
  • Fax:
Mailing address:
  • Phone: 978-223-8233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: