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Individual

TAMMY L MORIARTY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
200 SILVER ST, AGAWAM, MA 01001-3065
(413) 612-4360
Mailing address
25 SPRING VALLEY RD, EAST LONGMEADOW, MA 01028-2512
(860) 965-1843

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
17569
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
17569
COMMONWEALTH OF MASSACHUSETTS DIVISION OF OCCUPATIONAL LICENSURE
MA
Enumeration date
05/18/2023
Last updated
05/18/2023
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