Provider Demographics
NPI:1225453293
Name:DRUAN, MARIA ELENA KATERINA
Entity Type:Individual
Prefix:
First Name:MARIA ELENA
Middle Name:KATERINA
Last Name:DRUAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:MA
Mailing Address - Zip Code:02359-2917
Mailing Address - Country:US
Mailing Address - Phone:617-816-4757
Mailing Address - Fax:781-754-0131
Practice Address - Street 1:132 ROBBS HILL RD
Practice Address - Street 2:
Practice Address - City:LUNENBURG
Practice Address - State:MA
Practice Address - Zip Code:01462-2167
Practice Address - Country:US
Practice Address - Phone:774-270-1766
Practice Address - Fax:508-861-0206
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-27
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health