Provider Demographics
NPI:1114960572
Name:GRIECO, RACHEL D (PSYD)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:D
Last Name:GRIECO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 LOWELL ST
Mailing Address - Street 2:SUITE 2-J
Mailing Address - City:WILMINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01887-3087
Mailing Address - Country:US
Mailing Address - Phone:781-392-4429
Mailing Address - Fax:
Practice Address - Street 1:230 LOWELL ST
Practice Address - Street 2:SUITE 2-J
Practice Address - City:WILMINGTON
Practice Address - State:MA
Practice Address - Zip Code:01887-3087
Practice Address - Country:US
Practice Address - Phone:781-392-4429
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8572103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA7816460500OtherPHONE NUMBER