Provider Demographics
NPI:1023256336
Name:GURUCHARRI, MARIA CARMEL (EDD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:CARMEL
Last Name:GURUCHARRI
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:90 WARREN AVE
Mailing Address - Street 2:MCKINLEY ELEMENTARY
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116
Mailing Address - Country:US
Mailing Address - Phone:617-635-9978
Mailing Address - Fax:617-635-9985
Practice Address - Street 1:90 WARREN AVE
Practice Address - Street 2:MCKINLEY ELEMENTARY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116
Practice Address - Country:US
Practice Address - Phone:617-635-9978
Practice Address - Fax:617-635-9985
Is Sole Proprietor?:No
Enumeration Date:2009-01-23
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA3747103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent