MEDICARE: TINA M HEALY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1366219966
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TINA M HEALY

Provider Business Mailing Address
First Line	:	225 CEDAR HILL ST STE 200
Second Line	:
City	:	MARLBOROUGH
State	:	MA
Zip	:	01752-5900
Country	:	US
Telephone Number	:	141-353-0419
Fax Number	:

Provider Business Practice Location Address
First Line	:	5 LINDOR HTS
Second Line	:
City	:	HOLYOKE
State	:	MA
Zip	:	01040-1846
Country	:	US
Telephone Number	:	141-353-0419
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2023
Last Update Date	:	12/12/2023

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Directions to “ TINA M HEALY ” Practice Location

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