Provider Demographics
NPI:1962293092
Name:ECLIPSE, ILIANA RAIN (LE)
Entity type:Individual
Prefix:
First Name:ILIANA
Middle Name:RAIN
Last Name:ECLIPSE
Suffix:
Gender:F
Credentials:LE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 TRUMBULL RD
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3036
Mailing Address - Country:US
Mailing Address - Phone:413-393-9681
Mailing Address - Fax:
Practice Address - Street 1:31 TRUMBULL RD
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3036
Practice Address - Country:US
Practice Address - Phone:413-393-9681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2926225500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist