Provider Demographics
NPI:1497538714
Name:CLAY, TORIAN
Entity Type:Individual
Prefix:
First Name:TORIAN
Middle Name:
Last Name:CLAY
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 1:1309 BEACON ST STE 300
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-5252
Mailing Address - Country:US
Mailing Address - Phone:617-420-0425
Mailing Address - Fax:
Practice Address - Street 1:1309 BEACON ST STE 300
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-5252
Practice Address - Country:US
Practice Address - Phone:617-420-0425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-18
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician