Provider Demographics
NPI:1962622787
Name:MARANI, JACK S (BA)
Entity type:Individual
Prefix:
First Name:JACK
Middle Name:S
Last Name:MARANI
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
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Mailing Address - Street 1:E2 LYDON LN APT 5
Mailing Address - Street 2:
Mailing Address - City:HALIFAX
Mailing Address - State:MA
Mailing Address - Zip Code:02338-1408
Mailing Address - Country:US
Mailing Address - Phone:617-312-5349
Mailing Address - Fax:781-826-8193
Practice Address - Street 1:200 TER HEUN DR
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540-2525
Practice Address - Country:US
Practice Address - Phone:508-540-6550
Practice Address - Fax:508-540-7480
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)