Provider Demographics
NPI:1528597150
Name:TATE, MARCIA (BCBA)
Entity Type:Individual
Prefix:
First Name:MARCIA
Middle Name:
Last Name:TATE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 ROBBD HILL RD.
Mailing Address - Street 2:
Mailing Address - City:LUNENBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01462
Mailing Address - Country:US
Mailing Address - Phone:774-270-1766
Mailing Address - Fax:
Practice Address - Street 1:132 ROBBD HILL RD.
Practice Address - Street 2:
Practice Address - City:LUNENBURG
Practice Address - State:MA
Practice Address - Zip Code:01462
Practice Address - Country:US
Practice Address - Phone:774-270-1766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-07
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst