Provider Demographics
NPI:1437389855
Name:MEDERIOS, LAURI DAY
Entity Type:Individual
Prefix:MS
First Name:LAURI
Middle Name:DAY
Last Name:MEDERIOS
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 1:94 EDWARD ST
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-6656
Mailing Address - Country:US
Mailing Address - Phone:617-605-7404
Mailing Address - Fax:
Practice Address - Street 1:10 CABOT RD
Practice Address - Street 2:SUITE 209
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-5177
Practice Address - Country:US
Practice Address - Phone:781-395-0625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-20
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker