Provider Demographics
NPI:1477860534
Name:BARBETTI, ANN M (LIC AC)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:M
Last Name:BARBETTI
Suffix:
Gender:F
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 BRIGHT ST # 2
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453-6583
Mailing Address - Country:US
Mailing Address - Phone:781-642-0975
Mailing Address - Fax:
Practice Address - Street 1:1564A WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:HOLLISTON
Practice Address - State:MA
Practice Address - Zip Code:01746-2238
Practice Address - Country:US
Practice Address - Phone:508-429-3895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-09
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA237983171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist