Provider Demographics
NPI:1437474335
Name:SPAGNOLO, MARIA (LIC AC)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:SPAGNOLO
Suffix:
Gender:F
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 EAST INDIA SQUARE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-3700
Mailing Address - Country:US
Mailing Address - Phone:781-608-0171
Mailing Address - Fax:
Practice Address - Street 1:2 EAST INDIA SQUARE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-3700
Practice Address - Country:US
Practice Address - Phone:781-608-0171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-02
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist