Provider Demographics
NPI:1730966961
Name:DOE, REBECCA (RPSGT, CCSH)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:DOE
Suffix:
Gender:F
Credentials:RPSGT, CCSH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 MAIN ST UNIT 2
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:NH
Mailing Address - Zip Code:03240-3420
Mailing Address - Country:US
Mailing Address - Phone:978-270-5732
Mailing Address - Fax:
Practice Address - Street 1:18 OLD ETNA RD
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03766-1937
Practice Address - Country:US
Practice Address - Phone:603-650-3181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist