Provider Demographics
NPI:1174868954
Name:DEGIROLAMO, MARIE JOAN (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:JOAN
Last Name:DEGIROLAMO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 ROXANNE SQ
Mailing Address - Street 2:
Mailing Address - City:NORTH ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02760-4113
Mailing Address - Country:US
Mailing Address - Phone:508-316-0443
Mailing Address - Fax:
Practice Address - Street 1:500 CHAPMAN ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021-2093
Practice Address - Country:US
Practice Address - Phone:781-821-9955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-04
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8430225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics