Provider Demographics
NPI:1881214542
Name:JOSEPH, REBECCA (MS)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:JOSEPJ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:5501 LAKESIDE DR APT 205
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-7626
Mailing Address - Country:US
Mailing Address - Phone:786-353-7066
Mailing Address - Fax:
Practice Address - Street 1:721 SW 9TH ST
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33060-8215
Practice Address - Country:US
Practice Address - Phone:786-353-7066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-23
Last Update Date:2022-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty