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General NPI Number Information
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NPI Number | 1902714652
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Entity Type | Individual
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Provider Name | TANYA WILE WASSERBOEHR
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Gender | Female
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Dates
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Enumeration Date | 09/01/2026
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Last Update Date | 09/01/2026
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Provider Practice Location Address
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Address Line | 7A CYPRESS DR
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City | BURLINGTON
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State | MA
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Zip | 01803-4907
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Country | US
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Telephone | 781-328-0951
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Fax |
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Provider Business Mailing Address
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Address Line | 6 SARAFINA WAY
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City | WILMINGTON
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State | MA
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Zip | 01887-4554
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Country | US
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Telephone |
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Fax | 978-408-9662
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State | MA
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