Most Relevant Information
Provider Data
| NPI Number: | 1003534314 |
| Provider Name: | TANYA LOVELY JOSEPH RECOVERY SPECIALIST |
| Entity Type: | Individual |
| Taxonomy Code: | 261QR0800X |
| Specialty: | Clinic/Center |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/22/2022 |
| Last Updated: | 08/22/2022 |
Provider Practice Location
302 EUSTIS ST
ROXBURY
MA
021193800
Practice Location Phone/Fax
| Phone: | 6174451123 |
| Fax: |
Provider Mailing Location
302 EUSTIS ST
ROXBURY
MA
021193800
Provider Mailing Phone/Fax
| Phone: | 8572122771 |
| Fax: |