Provider Demographics
NPI:1316379563
Name:AYER INTEGRATIVE THERAPIES
Entity Type:Organization
Organization Name:AYER INTEGRATIVE THERAPIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:GWYN
Authorized Official - Middle Name:M
Authorized Official - Last Name:CATTELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-480-0003
Mailing Address - Street 1:10 EAST ST
Mailing Address - Street 2:
Mailing Address - City:AYER
Mailing Address - State:MA
Mailing Address - Zip Code:01432-1805
Mailing Address - Country:US
Mailing Address - Phone:978-480-0003
Mailing Address - Fax:
Practice Address - Street 1:10 EAST ST
Practice Address - Street 2:
Practice Address - City:AYER
Practice Address - State:MA
Practice Address - Zip Code:01432-1805
Practice Address - Country:US
Practice Address - Phone:978-480-0003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-30
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health