Provider Demographics
NPI:1225358583
Name:RANEY, MARILYN (MS)
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:
Last Name:RANEY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 CHESTNUT ST
Mailing Address - Street 2:APT #1
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453-4477
Mailing Address - Country:US
Mailing Address - Phone:617-512-2349
Mailing Address - Fax:
Practice Address - Street 1:24 CHESTNUT ST
Practice Address - Street 2:APT #1
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02453-4477
Practice Address - Country:US
Practice Address - Phone:617-512-2349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-09
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health