Provider Demographics
NPI:1346734852
Name:COBO, REBECCA S (RBT)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:S
Last Name:COBO
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 NW EGRET CT
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-9532
Mailing Address - Country:US
Mailing Address - Phone:731-343-3992
Mailing Address - Fax:
Practice Address - Street 1:955 NW EGRET CT
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-9532
Practice Address - Country:US
Practice Address - Phone:731-343-3992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-18
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-1857195106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician