Provider Demographics
NPI:1376060202
Name:GARAND, RENEE
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:GARAND
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 1:504 TALBOT AVE UNIT 3
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02124-3755
Mailing Address - Country:US
Mailing Address - Phone:802-522-3039
Mailing Address - Fax:
Practice Address - Street 1:555 AMORY ST
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-2652
Practice Address - Country:US
Practice Address - Phone:802-522-3039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-22
Last Update Date:2017-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker