Individual
TANYA MARIE BARBOSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
77 MASSACHUSETTS AVE, MIT BOX 397404, CAMBRIDGE, MA 02139-4301
(617) 253-4908
Mailing address
39 RIDGECREST TER APT 10, WEST ROXBURY, MA 02132-5254
(401) 996-3317
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1717
MA
Other
Enumeration date
02/23/2007
Last updated
07/08/2007
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