Provider Demographics
NPI:1619093671
Name:DEMAIO, SONIA LOPEZ (MED, LADC1)
Entity Type:Individual
Prefix:MRS
First Name:SONIA
Middle Name:LOPEZ
Last Name:DEMAIO
Suffix:
Gender:F
Credentials:MED, LADC1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 MAYFLOWER RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01118-1407
Mailing Address - Country:US
Mailing Address - Phone:413-478-4829
Mailing Address - Fax:
Practice Address - Street 1:1847 MEMORIAL DR STE 3B
Practice Address - Street 2:
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01020-3173
Practice Address - Country:US
Practice Address - Phone:413-478-4829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA692101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)