Provider Demographics
NPI:1215592365
Name:DANSIE, REBECCA AIMEE
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:AIMEE
Last Name:DANSIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:AIMEE
Other - Last Name:DANSIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5808 MISSOURI AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-2719
Mailing Address - Country:US
Mailing Address - Phone:760-646-2312
Mailing Address - Fax:
Practice Address - Street 1:5808 MISSOURI AVE APT 4
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-2719
Practice Address - Country:US
Practice Address - Phone:760-646-2312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-03
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1989206106S00000X
FL22-240541106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician