Provider Demographics
NPI:1710273859
Name:FOUR, REBECA (DOULA, IBCLC)
Entity Type:Individual
Prefix:MS
First Name:REBECA
Middle Name:
Last Name:FOUR
Suffix:
Gender:F
Credentials:DOULA, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 NEWARK ST STE 404C
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-4543
Mailing Address - Country:US
Mailing Address - Phone:201-657-1727
Mailing Address - Fax:
Practice Address - Street 1:51 NEWARK ST STE 404C
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-4543
Practice Address - Country:US
Practice Address - Phone:201-657-1727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-28
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No374J00000XNursing Service Related ProvidersDoula