Provider Demographics
NPI:1306944954
Name:DUBIN, RINA L (EDD)
Entity type:Individual
Prefix:DR
First Name:RINA
Middle Name:L
Last Name:DUBIN
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 WALPOLE ST SUITE 4
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062
Mailing Address - Country:US
Mailing Address - Phone:781-762-0880
Mailing Address - Fax:781-762-6808
Practice Address - Street 1:45 WALPOLE ST SUITE 4
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062
Practice Address - Country:US
Practice Address - Phone:781-762-0880
Practice Address - Fax:781-762-6808
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2384103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0515213Medicaid
MA0515213Medicaid