Provider Demographics
NPI:1205858537
Name:AQUADRO, MARY ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARY ANN
Middle Name:
Last Name:AQUADRO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3076 DINKY LN
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-7424
Mailing Address - Country:US
Mailing Address - Phone:615-225-4548
Mailing Address - Fax:615-225-4611
Practice Address - Street 1:3400 LEBANON RD
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-1237
Practice Address - Country:US
Practice Address - Phone:615-225-4548
Practice Address - Fax:615-225-4611
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2008-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist