Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | ||
N | 1041C0700X | Clinical Social Worker | 121028 | MA |
NPI | 1003066283 |
---|---|
Provider Name | Mrs. Erin Wild Rioux |
First Address | Brighton, MA 02135-3601 |
Second Address | Salem, MA 01970-3452 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2008 |
Last Update Date | 28/10/2020 |