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General NPI Number Information
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NPI Number | 1326434598
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Entity Type | Organization
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Legal Business Name | DAVID RAINEN, PSYD LLC
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Dates
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Enumeration Date | 04/14/2015
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Last Update Date | 04/14/2015
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Provider Practice Location Address
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Address Line | 10 ESSEX ST SUITE 8
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City | ANDOVER
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State | MA
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Zip | 01810-3729
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Country | US
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Telephone | 978-282-7063
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Fax | 978-975-4149
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Provider Business Mailing Address
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Address Line | 10 ESSEX ST SUITE 8
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City | ANDOVER
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State | MA
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Zip | 01810-3729
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID RAINEN
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Credential |
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Telephone | 978-502-5398
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 10095
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License Number State | MA
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