Provider Demographics
NPI:1407827637
Name:POLLACK, REBECCA ANNE (MS, CGC)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:ANNE
Last Name:POLLACK
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 KINGSBURY DR
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82609-3116
Mailing Address - Country:US
Mailing Address - Phone:307-377-2554
Mailing Address - Fax:307-232-9103
Practice Address - Street 1:1400 KINGSBURY DR
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82609-3116
Practice Address - Country:US
Practice Address - Phone:307-377-2554
Practice Address - Fax:307-232-9103
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS