Provider Demographics
NPI:1073989414
Name:LANIER, REBECCA (EDS, MED)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:LANIER
Suffix:
Gender:F
Credentials:EDS, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5867 WHITAKER RD
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34112-2963
Mailing Address - Country:US
Mailing Address - Phone:239-774-2904
Mailing Address - Fax:239-774-1438
Practice Address - Street 1:5867 WHITAKER RD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34112-2963
Practice Address - Country:US
Practice Address - Phone:239-774-2904
Practice Address - Fax:239-774-1438
Is Sole Proprietor?:No
Enumeration Date:2015-08-20
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist