Provider Demographics
NPI:1710215298
Name:BARON, BETH ALISA (SEP, LMT, CMTPT, CPT)
Entity type:Individual
Prefix:MS
First Name:BETH
Middle Name:ALISA
Last Name:BARON
Suffix:
Gender:F
Credentials:SEP, LMT, CMTPT, CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:SHELBURNE FALLS
Mailing Address - State:MA
Mailing Address - Zip Code:01370-1205
Mailing Address - Country:US
Mailing Address - Phone:413-432-9442
Mailing Address - Fax:510-473-3736
Practice Address - Street 1:27 HIGH ST
Practice Address - Street 2:
Practice Address - City:SHELBURNE FALLS
Practice Address - State:MA
Practice Address - Zip Code:01370-1205
Practice Address - Country:US
Practice Address - Phone:413-432-9442
Practice Address - Fax:510-473-3736
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-22
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
MA17315225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No174400000XOther Service ProvidersSpecialist