Individual
MARIA TIAGO TAVARES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
28 HOWARD SQ, BROCKTON, MA 02301-5113
(774) 417-4090
Mailing address
28 HOWARD SQ, BROCKTON, MA 02301-5113
(774) 417-4090
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
01/07/2016
Last updated
12/11/2021
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