Provider Demographics
NPI:1275110116
Name:COBBS, TAMI A
Entity Type:Individual
Prefix:
First Name:TAMI
Middle Name:A
Last Name:COBBS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 2ND AVE UNIT 5034
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02494-3072
Mailing Address - Country:US
Mailing Address - Phone:857-499-4073
Mailing Address - Fax:
Practice Address - Street 1:275 2ND AVE UNIT 5034
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02494-3072
Practice Address - Country:US
Practice Address - Phone:857-499-4073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-26
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA14795225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist