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General NPI Number Information
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NPI Number | 1366162844
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Entity Type | Individual
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Provider Name | KATIE NICOLE MARASCO LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/02/2022
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Last Update Date | 09/02/2022
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Provider Practice Location Address
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Address Line | 20 TOWER OFFICE PARK
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City | WOBURN
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State | MA
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Zip | 01801-2113
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Country | US
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Telephone | 781-305-3300
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Fax | 781-305-3227
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Provider Business Mailing Address
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Address Line | 43 COLUMBIA ST
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City | WILMINGTON
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State | MA
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Zip | 01887-2463
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Country | US
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Telephone | 978-604-5330
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 228343
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License Number State | MA
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