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NPI Code Detail

MEDICARE: DENNIS MORAN

MEDICARE: DENNIS MORAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1699450916
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENNIS MORAN
Provider Business Mailing Address
First Line : 210 GRANITE AVE
Second Line :
City : MILTON
State : MA
Zip : 02186-4343
Country : US
Telephone Number : 857-221-0018
Fax Number :
Provider Business Practice Location Address
First Line : 49 WALTHAM ST STE 2
Second Line :
City : LEXINGTON
State : MA
Zip : 02421-5411
Country : US
Telephone Number : 617-615-6155
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2023
Last Update Date : 06/15/2023

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Directions to “ DENNIS MORAN ” Practice Location

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