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General NPI Number Information
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NPI Number | 1790882611
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Entity Type | Organization
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Legal Business Name | MR. JOHN F. DEMURO, LICSW
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 20 MAIN ST SUITE 305B
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City | NATICK
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State | MA
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Zip | 01760-4525
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Country | US
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Telephone | 508-651-7033
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Fax |
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Provider Business Mailing Address
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Address Line | 20 MAIN ST SUITE 305B
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City | NATICK
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State | MA
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Zip | 01760-4525
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Country | US
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Telephone | 508-651-7033
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Fax |
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Authorized Official
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Title or Position | PARENT, CHILD, AND FAMILY THERAPIST
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Name | MR. JOHN FRANCIS DEMURO I
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Credential | LICSW
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Telephone | 508-651-7033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 106136
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License Number State | MA
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