Provider Demographics
NPI:1841681830
Name:ALDRICH, TINA C
Entity type:Individual
Prefix:MRS
First Name:TINA
Middle Name:C
Last Name:ALDRICH
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 MOUNT WAYTE AVE
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-5803
Mailing Address - Country:US
Mailing Address - Phone:508-250-0770
Mailing Address - Fax:508-875-1308
Practice Address - Street 1:73 MOUNT WAYTE AVE
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-5803
Practice Address - Country:US
Practice Address - Phone:508-250-0770
Practice Address - Fax:508-875-1308
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-11
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1891225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist