Basic Information
| Provider Information | |||||||||
| NPI: | 1457631830 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SAMARINA | ||||||||
| FirstName: | VIKTORIYA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 280 CHESTNUT ST | ||||||||
| Address2: | FL 2 | ||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011990119 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137943909 | ||||||||
| FaxNumber: | 4137943909 | ||||||||
| Practice Location | |||||||||
| Address1: | 3300 MAIN ST | ||||||||
| Address2: | SUITE 4 A&B | ||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011991002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137940000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/17/2011 | ||||||||
| LastUpdateDate: | 12/02/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 10475 | MA | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.