MEDICARE: MRS. JENNIFER MARION RIEMER LICSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	111791	MA

General Provider Information

NPI Number	:	1790883932
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNIFER MARION RIEMER LICSW

Provider Business Mailing Address
First Line	:	1 NEWBURY ST
Second Line	:
City	:	HOPKINTON
State	:	MA
Zip	:	01748-2727
Country	:	US
Telephone Number	:	508-625-1550
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 ASYLUM ST
Second Line	:
City	:	MILFORD
State	:	MA
Zip	:	01757-2203
Country	:	US
Telephone Number	:	508-478-6888
Fax Number	:	508-478-9042

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	07/08/2007

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