Provider Demographics
NPI:1114598224
Name:STUBBS, REBECCA MARIE SORCE
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:MARIE SORCE
Last Name:STUBBS
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 1:575 SEA ST APT 2
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-2835
Mailing Address - Country:US
Mailing Address - Phone:928-533-8531
Mailing Address - Fax:
Practice Address - Street 1:1125 CENTRE ST
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-3495
Practice Address - Country:US
Practice Address - Phone:928-533-8531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-09
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical