Doctor Name: | JOHN M. PRATICO |
NPI Number: | 1023241049 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 131 Rantoul St Beverly, MA - 019154240 |
Business Phone Number: | 9785240175 |
Business Fax Number: | 9785240214 |
Mailing Address: | Po Box 1115, WEST BROOKFIELD |
State: | MA |
Postal Code: | 015851115 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 08/25/2009 |
NPI Last Update Date: | 08/25/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |