Provider Demographics
NPI:1154621969
Name:MCNAMARA, CONCEPTA M (LMT)
Entity type:Individual
Prefix:MS
First Name:CONCEPTA
Middle Name:M
Last Name:MCNAMARA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02494-2913
Mailing Address - Country:US
Mailing Address - Phone:781-308-4247
Mailing Address - Fax:
Practice Address - Street 1:43 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02494-2913
Practice Address - Country:US
Practice Address - Phone:781-308-4247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-26
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4558225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist