Provider Demographics
NPI:1144056136
Name:COLOMBO, REBECCA (PHD)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:COLOMBO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 S BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-1901
Mailing Address - Country:US
Mailing Address - Phone:727-599-3624
Mailing Address - Fax:
Practice Address - Street 1:111 S BOULEVARD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-1901
Practice Address - Country:US
Practice Address - Phone:727-599-3624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool