Provider Demographics
NPI:1518591684
Name:HUBER, TINA (MA)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:
Last Name:HUBER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 HANCOCK ST STE 205
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-4371
Mailing Address - Country:US
Mailing Address - Phone:617-750-0183
Mailing Address - Fax:617-745-4170
Practice Address - Street 1:1212 HANCOCK ST STE 205
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-4371
Practice Address - Country:US
Practice Address - Phone:617-750-0183
Practice Address - Fax:617-745-4170
Is Sole Proprietor?:No
Enumeration Date:2020-02-27
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist