Provider Demographics
NPI:1639493190
Name:SIENKIEWICZ, REBECCA ROSE (MSW)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:ROSE
Last Name:SIENKIEWICZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18357 CLAIRMONT CIR W
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48168-8547
Mailing Address - Country:US
Mailing Address - Phone:248-974-2055
Mailing Address - Fax:
Practice Address - Street 1:18357 CLAIRMONT CIR W
Practice Address - Street 2:
Practice Address - City:NORTHVILLE
Practice Address - State:MI
Practice Address - Zip Code:48168-8547
Practice Address - Country:US
Practice Address - Phone:248-974-2055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-26
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical