Provider Demographics
NPI:1942419585
Name:DEMARCO, MARY E (COTAL CMT)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:E
Last Name:DEMARCO
Suffix:
Gender:F
Credentials:COTAL CMT
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Mailing Address - Street 1:946 GREAT PLAIN AVE
Mailing Address - Street 2:PMB 361
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492-3030
Mailing Address - Country:US
Mailing Address - Phone:617-780-1579
Mailing Address - Fax:
Practice Address - Street 1:3 BURLINGTON WOODS
Practice Address - Street 2:SUITE 304
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-4514
Practice Address - Country:US
Practice Address - Phone:781-270-0222
Practice Address - Fax:781-270-5005
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA865224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant