Provider Demographics
NPI:1891895512
Name:REUSCH, REBA TYLER (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:REBA
Middle Name:TYLER
Last Name:REUSCH
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 HIGH ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:CLINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01510-2922
Mailing Address - Country:US
Mailing Address - Phone:978-365-8000
Mailing Address - Fax:978-365-7561
Practice Address - Street 1:70 HIGH ST
Practice Address - Street 2:SUITE 206
Practice Address - City:CLINTON
Practice Address - State:MA
Practice Address - Zip Code:01510-2922
Practice Address - Country:US
Practice Address - Phone:978-365-8000
Practice Address - Fax:978-365-7561
Is Sole Proprietor?:No
Enumeration Date:2006-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10275351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical