Organization
THE KIOKO CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA MCCORMICK OTD OTR/L (BUSINESS OWNER/LEADING OT)
(978) 681-6605
Entity
Organization
Contact information
Practice address
820 TURNPIKE ST, SUITE 104, NORTH ANDOVER, MA 01845-6125
(978) 681-6605
(978) 681-6601
Mailing address
820 TURNPIKE ST, SUITE 104, NORTH ANDOVER, MA 01845-6125
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
727452
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1790089399
BLUE CROSS BLUE SHIELD & HARVARD PILGRIM
—
Enumeration date
01/13/2011
Last updated
01/13/2011
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