Provider Demographics
NPI:1447842869
Name:MAGRANE, DYLAN
Entity type:Individual
Prefix:
First Name:DYLAN
Middle Name:
Last Name:MAGRANE
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:PO BOX 462
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03264-0462
Mailing Address - Country:US
Mailing Address - Phone:603-481-1481
Mailing Address - Fax:
Practice Address - Street 1:206 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:WOODSVILLE
Practice Address - State:NH
Practice Address - Zip Code:03785-1321
Practice Address - Country:US
Practice Address - Phone:603-747-3363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-08
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool