| Doctor Name: | MR. BRANDEN ANGELO DEMARCO |
| NPI Number: | 1023209806 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | EDS |
| License Number: | |
| Business Practice Address: | 1004 Hancock Road Suite 100 Bullhead City, AZ - 86442 |
| Business Phone Number: | 9287586871 |
| Business Fax Number: | 9287586834 |
| Mailing Address: | 1004 Hancock Road, Suite 100 BULLHEAD CITY |
| State: | AZ |
| Postal Code: | 86442 |
| Phone Number: | 9287586871 |
| Fax Number: | 9287586834 |
| NPI Enumeration Date: | 08/06/2007 |
| NPI Last Update Date: | 08/29/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TS0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |