Provider Demographics
NPI:1669631958
Name:LEE-KAFFAR, REBECCA LYNN (MSW)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:LYNN
Last Name:LEE-KAFFAR
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:PO BOX 5046
Mailing Address - Street 2:2501 W 22ND ST
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5046
Mailing Address - Country:US
Mailing Address - Phone:605-336-3230
Mailing Address - Fax:605-333-5305
Practice Address - Street 1:2501 W 22ND ST
Practice Address - Street 2:VA MEDICAL CENTER
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57117-5046
Practice Address - Country:US
Practice Address - Phone:605-336-3230
Practice Address - Fax:605-333-5305
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1893104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker