Individual
MR. THOMAS EDWARD MAGNAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADCI
Contact information
Practice address
49 L ST, SOUTH BOSTON, MA 02127-1511
(617) 268-5000
(617) 268-5008
Mailing address
49 L ST, SOUTH BOSTON, MA 02127-1511
(617) 268-5000
(617) 268-5008
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1369
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1369
LADCI
MA
Enumeration date
07/01/2010
Last updated
07/01/2010
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