Provider Demographics
NPI:1912138975
Name:CABLE, THURAYA ANASTAS (LAC, DIPL OM, CMT)
Entity type:Individual
Prefix:
First Name:THURAYA
Middle Name:ANASTAS
Last Name:CABLE
Suffix:
Gender:F
Credentials:LAC, DIPL OM, CMT
Other - Prefix:
Other - First Name:THURAYA
Other - Middle Name:ANASTAS
Other - Last Name:CABLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC, DIPL OM, CMT
Mailing Address - Street 1:245 RUSSELL ST STE 5
Mailing Address - Street 2:
Mailing Address - City:HADLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01035-9563
Mailing Address - Country:US
Mailing Address - Phone:617-863-2312
Mailing Address - Fax:
Practice Address - Street 1:245 RUSSELL ST STE 5
Practice Address - Street 2:
Practice Address - City:HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01035-9563
Practice Address - Country:US
Practice Address - Phone:617-863-2312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-06
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 12545171100000X
VT091.0052417171100000X
MA242589171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist