Provider Demographics
NPI:1730815515
Name:NGUYEN, TERESA
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:NGUYEN
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 1:225 CEDAR HILL ST STE 200
Mailing Address - Street 2:
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-5900
Mailing Address - Country:US
Mailing Address - Phone:781-468-6447
Mailing Address - Fax:
Practice Address - Street 1:800 BOYLSTON ST FL 16
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02199-1900
Practice Address - Country:US
Practice Address - Phone:617-812-9454
Practice Address - Fax:855-568-2494
Is Sole Proprietor?:No
Enumeration Date:2022-07-25
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician