Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 1017577 | MA |
NPI | 1003259326 |
---|---|
Provider Name | John Francis Didio |
First Address | Lawrence, MA 01840-1244 |
Second Address | Lawrence, MA 01840-1244 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2013 |
Last Update Date | 17/04/2013 |