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General NPI Number Information
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NPI Number | 1487129821
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Entity Type | Individual
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Provider Name | SAMANTHA PAIGE REIF LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/12/2018
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Last Update Date | 10/12/2018
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Provider Practice Location Address
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Address Line | 675 MAIN ST
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City | WALTHAM
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State | MA
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Zip | 02451-0602
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Country | US
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Telephone | 781-893-2003
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Fax |
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Provider Business Mailing Address
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Address Line | 12 SUTHERLAND RD APT 3
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City | BRIGHTON
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State | MA
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Zip | 02135-7002
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Country | US
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Telephone | 570-939-0333
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 223459
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License Number State | MA
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