Healthcare Provider Details

I. General information

NPI: 1043660384
Provider Name (Legal Business Name): LAURA A MARIOTTI LMFT, MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAURA A PALUSO

II. Dates (important events)

Enumeration Date: 06/17/2016
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 SOUTH ST
DRURY MA
01343-9616
US

IV. Provider business mailing address

28 SOUTH ST
DRURY MA
01343-9616
US

V. Phone/Fax

Practice location:
  • Phone: 970-642-4802
  • Fax:
Mailing address:
  • Phone: 970-642-4802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT.0001624
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: