Provider Demographics
NPI:1861919656
Name:DEWITT, REBECCA SANDERS
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:SANDERS
Last Name:DEWITT
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 1:13 OLD SOUTH ST STE 2H
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3841
Mailing Address - Country:US
Mailing Address - Phone:617-935-6169
Mailing Address - Fax:
Practice Address - Street 1:13 OLD SOUTH ST STE 2H
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3841
Practice Address - Country:US
Practice Address - Phone:617-935-6169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-23
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical