Provider Demographics
NPI:1689832057
Name:REINHOLD, GEOFFREY SCOTT (MS OTR/L)
Entity Type:Individual
Prefix:MR
First Name:GEOFFREY
Middle Name:SCOTT
Last Name:REINHOLD
Suffix:
Gender:M
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 RANDOLPH ST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-2351
Mailing Address - Country:US
Mailing Address - Phone:781-830-8563
Mailing Address - Fax:
Practice Address - Street 1:3 RANDOLPH ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021-2351
Practice Address - Country:US
Practice Address - Phone:781-830-8563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-01
Last Update Date:2008-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7659225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist