Provider Demographics
NPI:1558007252
Name:WINIARSKI, BRYNN
Entity Type:Individual
Prefix:
First Name:BRYNN
Middle Name:
Last Name:WINIARSKI
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 1:73 NEWBURY ST STE 400
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-3053
Mailing Address - Country:US
Mailing Address - Phone:617-839-3707
Mailing Address - Fax:
Practice Address - Street 1:73 NEWBURY ST STE 400
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-3053
Practice Address - Country:US
Practice Address - Phone:617-839-3707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-06
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician