Provider Demographics
NPI:1659998656
Name:LIANG, MARIE TARAS (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARIE
Middle Name:TARAS
Last Name:LIANG
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 1:90 SWEETWATER AVE
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01730-1106
Mailing Address - Country:US
Mailing Address - Phone:781-275-1249
Mailing Address - Fax:
Practice Address - Street 1:90 SWEETWATER AVE
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:01730-1106
Practice Address - Country:US
Practice Address - Phone:781-275-1249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-25
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6716103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Single Specialty