Provider Demographics
NPI:1043524101
Name:DEMARIA, MARION ALESSANDRA (MA)
Entity Type:Individual
Prefix:MRS
First Name:MARION
Middle Name:ALESSANDRA
Last Name:DEMARIA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 E ORANGE ST
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-7767
Mailing Address - Country:US
Mailing Address - Phone:303-332-6690
Mailing Address - Fax:
Practice Address - Street 1:1345 CLAY ST
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-5404
Practice Address - Country:US
Practice Address - Phone:407-622-0202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-01
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH8358101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health