Provider Demographics
NPI:1801914478
Name:DELAVAN, REBECCA APRIL
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:APRIL
Last Name:DELAVAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1318 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-2617
Mailing Address - Country:US
Mailing Address - Phone:541-744-9226
Mailing Address - Fax:
Practice Address - Street 1:1790 11TH AVE W
Practice Address - Street 2:STE 290
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402
Practice Address - Country:US
Practice Address - Phone:541-345-4244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health