| Doctor Name: | MRS. JEANINE COPELAND DERANIAN |
| NPI Number: | 1215066683 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A., LMHC |
| License Number: | 4864 |
| Business Practice Address: | 206 Milford St Upton, MA - 015681309 |
| Business Phone Number: | 5085297000 |
| Business Fax Number: | |
| Mailing Address: | 7 Waterville Cir, NORTH GRAFTON |
| State: | MA |
| Postal Code: | 015361810 |
| Phone Number: | 5088396250 |
| Fax Number: | |
| NPI Enumeration Date: | 03/03/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 4864 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |