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General NPI Number Information
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NPI Number | 1073958757
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Entity Type | Individual
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Provider Name | MEGHAN ANN TIERNEY OT
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Gender | Female
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Dates
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Enumeration Date | 05/08/2013
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Last Update Date | 05/04/2017
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Provider Practice Location Address
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Address Line | 55 FOGG RD
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City | SOUTH WEYMOUTH
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State | MA
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Zip | 02190-2432
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Country | US
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Telephone | 781-624-8303
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Fax |
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Provider Business Mailing Address
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Address Line | 50 AIRPORT RD
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City | QUINCY
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State | MA
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Zip | 02171-1526
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Country | US
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Telephone | 617-347-0982
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 10045
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License Number State | MA
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