Provider Demographics
NPI:1841486701
Name:DIORIO, MARILYN M (LADC I)
Entity type:Individual
Prefix:
First Name:MARILYN
Middle Name:M
Last Name:DIORIO
Suffix:
Gender:F
Credentials:LADC I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 ALDEN ST
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:MA
Mailing Address - Zip Code:02176-4404
Mailing Address - Country:US
Mailing Address - Phone:617-629-6668
Mailing Address - Fax:
Practice Address - Street 1:167 HOLLAND ST
Practice Address - Street 2:RM 133
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02144-2401
Practice Address - Country:US
Practice Address - Phone:617-629-6668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-24
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)