MEDICARE: DR. ASHLEY DEMARCO PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	38554	TX
2	103T00000X	Psychologist	PSY20230010	NM

General Provider Information

NPI Number	:	1528565496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASHLEY DEMARCO PH.D.

Provider Business Mailing Address
First Line	:	1501 SAN PEDRO DR SE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87108-5153
Country	:	US
Telephone Number	:	505-265-1711
Fax Number	:

Provider Business Practice Location Address
First Line	:	1501 SAN PEDRO DR SE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87108-5153
Country	:	US
Telephone Number	:	505-265-1711
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2018
Last Update Date	:	06/08/2026

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Directions to “ DR. ASHLEY DEMARCO PH.D.” Practice Location

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