Provider Demographics
NPI:1841005436
Name:DURBANO, TEREZ MARIE
Entity type:Individual
Prefix:
First Name:TEREZ
Middle Name:MARIE
Last Name:DURBANO
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 1:28 RAILROAD AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-4997
Mailing Address - Country:US
Mailing Address - Phone:401-226-9963
Mailing Address - Fax:
Practice Address - Street 1:11 CIRCLE AVE
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01905-3050
Practice Address - Country:US
Practice Address - Phone:781-346-9941
Practice Address - Fax:781-598-0210
Is Sole Proprietor?:No
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)