Provider Demographics
NPI:1518071083
Name:BOIS, TERESA MCGINN (LICAC)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:MCGINN
Last Name:BOIS
Suffix:
Gender:F
Credentials:LICAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 MIRICK RD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:MA
Mailing Address - Zip Code:01541-1111
Mailing Address - Country:US
Mailing Address - Phone:978-342-4400
Mailing Address - Fax:781-598-4734
Practice Address - Street 1:646 CENTRAL ST STE 1C
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-6138
Practice Address - Country:US
Practice Address - Phone:781-599-2711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA216175171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist