Provider Demographics
NPI:1518631951
Name:BUNN, REBECCA REIDY (PHD)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:REIDY
Last Name:BUNN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:REIDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:26 BELDEN AVE UNIT 1419
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06850-3368
Mailing Address - Country:US
Mailing Address - Phone:609-213-4149
Mailing Address - Fax:
Practice Address - Street 1:330 POST RD
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-3600
Practice Address - Country:US
Practice Address - Phone:203-202-7654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-08
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist