Healthcare Provider Details

I. General information

NPI: 1386384501
Provider Name (Legal Business Name): TORIA HOPE LIELASUS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2022
Last Update Date: 03/29/2022
Certification Date: 03/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 FOSTER ST
WORCESTER MA
01608-1715
US

IV. Provider business mailing address

PO BOX 92
ASHBY MA
01431-0092
US

V. Phone/Fax

Practice location:
  • Phone: 774-243-3477
  • Fax:
Mailing address:
  • Phone: 978-868-8843
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: