1598839169 NPI number — MS. BARBARA JEANNE MARRIOTT ATR BC

Table of content: MS. BARBARA JEANNE MARRIOTT ATR BC (NPI 1598839169)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598839169 NPI number — MS. BARBARA JEANNE MARRIOTT ATR BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MARRIOTT
Provider First Name:
BARBARA
Provider Middle Name:
JEANNE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
ATR BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598839169
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
32 RIVERVIEW AVENUE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WALTHAM
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02453-3818
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-893-9561
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
789 CLAPBOARDTREE STREET
Provider Second Line Business Practice Location Address:
HARBOR COUNSELING
Provider Business Practice Location Address City Name:
WESTWOOD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02090
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-762-4001
Provider Business Practice Location Address Fax Number:
781-461-5950
Provider Enumeration Date:
11/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 221700000X , with the licence number:  87125 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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