Provider Demographics
NPI:1558511568
Name:MURPHY, TRACEY BORRIELLO (PHD)
Entity Type:Individual
Prefix:DR
First Name:TRACEY
Middle Name:BORRIELLO
Last Name:MURPHY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:WRENTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02093-1455
Mailing Address - Country:US
Mailing Address - Phone:508-384-7417
Mailing Address - Fax:
Practice Address - Street 1:500 FRANKLIN VILLAGE DR STE 212
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:MA
Practice Address - Zip Code:02038-4017
Practice Address - Country:US
Practice Address - Phone:508-498-4808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-26
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA909103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool