Brandy Ditomasso, LMT

Individual provider Active NPI Specialist · Leicester, MA

NPI 1497021802 · NPPES record last updated Mar 29, 2012

Key facts

NPI
1497021802
Entity type
Individual (NPI type 1)
Primary specialty
Specialist 174400000X
License
9780 (MA)
Practice address
1069 Main St
Leicester, MA 01524-1324
Phone
(508) 892-5595
NPI assigned
Mar 29, 2012
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X 9780 MA
Specialist 174400000X 9780 MA Yes

Addresses

Primary practice location

1069 Main St
Leicester, MA 01524-1324

Mailing address

1069 Main St
Leicester, MA 01524-1324
Phone (508) 892-5595

Other providers in Leicester, MA

All providers in Leicester, MA · Specialist in Massachusetts

Sources for this page

Verify at the official NPI Registry.