Provider Demographics
NPI:1871673590
Name:RABINOVITCH, MIRIAM (MSW)
Entity Type:Individual
Prefix:
First Name:MIRIAM
Middle Name:
Last Name:RABINOVITCH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:MIMI
Other - Middle Name:
Other - Last Name:RABINOVITCH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2077 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02462-1518
Mailing Address - Country:US
Mailing Address - Phone:617-527-1235
Mailing Address - Fax:
Practice Address - Street 1:2077 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02462-1518
Practice Address - Country:US
Practice Address - Phone:617-527-1235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1060211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical