Provider Demographics
NPI:1346841418
Name:REBECCA TUBBS PSYD PLLC
Entity Type:Organization
Organization Name:REBECCA TUBBS PSYD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:TUBBS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:978-307-8354
Mailing Address - Street 1:PO BOX 1083
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-1083
Mailing Address - Country:US
Mailing Address - Phone:978-307-8354
Mailing Address - Fax:978-636-6773
Practice Address - Street 1:336 BAKER AVE UNIT 1-14
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-2100
Practice Address - Country:US
Practice Address - Phone:978-307-8354
Practice Address - Fax:978-636-6773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-05
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty