Provider Demographics
NPI:1669799334
Name:WEINBERG, TARA LEIGH (MS ED)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:LEIGH
Last Name:WEINBERG
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 PROVIDENCE HWY
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-2624
Mailing Address - Country:US
Mailing Address - Phone:774-206-1125
Mailing Address - Fax:774-628-9657
Practice Address - Street 1:55 PROVIDENCE HWY
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-2624
Practice Address - Country:US
Practice Address - Phone:774-206-1125
Practice Address - Fax:774-628-9657
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-21
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist