Most Relevant Information
Provider Data
| NPI Number: | 1003047945 |
| Provider Name: | TIMOTHY ROY BA, MSW, LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 216014 |
Most Important Dates
| Enumeration Date: | 07/27/2009 |
| Last Updated: | 06/01/2010 |
Provider Practice Location
780 AMERICAN LEGION HWY
PRESCHOOL OUTREACH PROGRAM
BOSTON
MA
021313908
Practice Location Phone/Fax
| Phone: | 6174698500 |
| Fax: |
Provider Mailing Location
780 AMERICAN LEGION HWY
PRESCHOOL OUTREACH PROGRAM
BOSTON
MA
021313908
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |