Provider Demographics
NPI:1093934564
Name:ENGEN, REBECCA L (MT-BC, NMT)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:L
Last Name:ENGEN
Suffix:
Gender:F
Credentials:MT-BC, NMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 S 43RD ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53219-4844
Mailing Address - Country:US
Mailing Address - Phone:704-651-0348
Mailing Address - Fax:
Practice Address - Street 1:3400 S 43RD ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53219-4844
Practice Address - Country:US
Practice Address - Phone:704-651-0348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist