Tanycha Enid Bonilla

Individual provider Active NPI Behavior Technician · Hyde Park, MA

NPI 1629908512 · NPPES record last updated May 21, 2026

Key facts

NPI
1629908512
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
414150 (MA)
Practice address
1234 Hyde Park Ave
Hyde Park, MA 02136-2819
Phone
(888) 763-7272
Fax
(877) 243-2959
NPI assigned
May 21, 2026
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

State licenses

LicenseStateTypeSpecialty
414150MAMDBehavior Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 414150 MA Yes

Addresses

Primary practice location

1234 Hyde Park Ave
Hyde Park, MA 02136-2819

Mailing address

89 South St
Holbrook, MA 02343-2038
Phone (888) 763-7272

Other providers in Hyde Park, MA

All providers in Hyde Park, MA · Behavior Technician in Massachusetts

Sources for this page

Verify at the official NPI Registry.