Provider Demographics
NPI:1457631830
Name:SAMARINA, VIKTORIYA (PHD)
Entity Type:Individual
Prefix:DR
First Name:VIKTORIYA
Middle Name:
Last Name:SAMARINA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 CHESTNUT ST
Mailing Address - Street 2:FL 2
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-0119
Mailing Address - Country:US
Mailing Address - Phone:413-794-3909
Mailing Address - Fax:413-794-3909
Practice Address - Street 1:3300 MAIN ST
Practice Address - Street 2:SUITE 4 A&B
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01199-1002
Practice Address - Country:US
Practice Address - Phone:413-794-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-17
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10475103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical