Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156F00000X | Technician/Technologist |
NPI | 1215915491 |
---|---|
Provider Name | Mrs. Teresa Marshall-Bradbury |
First Address | Townsend, MA 01469-1257 |
Second Address | Worcester, MA 01605-2627 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2006 |
Last Update Date | 26/11/2019 |