Healthcare Provider Details

I. General information

NPI: 1922414929
Provider Name (Legal Business Name): ALLYSON TIEULI OT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALLYSON ORAM

II. Dates (important events)

Enumeration Date: 07/10/2014
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date: 10/06/2024
Reactivation Date: 03/24/2026

III. Provider practice location address

136 BOSTON POST RD
SUDBURY MA
01752
US

IV. Provider business mailing address

108 UPLAND RD
MARLBOROUGH MA
01752-1387
US

V. Phone/Fax

Practice location:
  • Phone: 978-443-2722
  • Fax:
Mailing address:
  • Phone: 774-249-8724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number12936
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: