| Doctor Name: | JOSHUA TANENBAUM |
| NPI Number: | 1336545193 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.S.S. |
| License Number: | 219830 |
| Business Practice Address: | 11 Depot Sq Ayer, MA - 014321372 |
| Business Phone Number: | 9787721846 |
| Business Fax Number: | |
| Mailing Address: | 117 Central St, Apt. E1 ACTON |
| State: | MA |
| Postal Code: | 017202748 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 11/06/2014 |
| NPI Last Update Date: | 11/06/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 219830 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |