Healthcare Provider Details

I. General information

NPI: 1861534554
Provider Name (Legal Business Name): ARLENE GRIFFIN TEICH MSW LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 QUINCY AVE COMMUNITY REHAB CARE
QUINCY MA
02169
US

IV. Provider business mailing address

3 VOSE LANE
E WALPOLE MA
02032
US

V. Phone/Fax

Practice location:
  • Phone: 617-786-8811
  • Fax: 617-786-8877
Mailing address:
  • Phone: 508-668-7832
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number113478
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: