Provider Demographics
NPI:1215402417
Name:MARIANI, ANTONIA
Entity Type:Individual
Prefix:MS
First Name:ANTONIA
Middle Name:
Last Name:MARIANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 MILL ST
Mailing Address - Street 2:MAIL STOP 238
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-1064
Mailing Address - Country:US
Mailing Address - Phone:617-869-6025
Mailing Address - Fax:
Practice Address - Street 1:115 MILL ST
Practice Address - Street 2:MAIL STOP 238
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-1048
Practice Address - Country:US
Practice Address - Phone:617-855-4469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-04
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1260021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical