Provider Demographics
NPI:1750908216
Name:HANDRICK, THOMAS
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:HANDRICK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 BARTON RD
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:MA
Mailing Address - Zip Code:01775-1529
Mailing Address - Country:US
Mailing Address - Phone:978-760-6614
Mailing Address - Fax:
Practice Address - Street 1:201 BARTON RD
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:MA
Practice Address - Zip Code:01775-1529
Practice Address - Country:US
Practice Address - Phone:978-760-6614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-01
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst