Individual
TAMMY A FRATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
10 E. LAKE ST., WORCESTER, MA 01604
(508) 733-9801
Mailing address
10 E LAKE ST, WORCESTER, MA 01604-1316
(508) 552-1874
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
16586
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16586
MASSAGE THERAPIST LICENSE
MA
01
—
HDR26831
COSMETOLOGY LICENSE
RI
Enumeration date
10/30/2024
Last updated
10/30/2024
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