Provider Demographics
NPI:1902420409
Name:MILLER, REBECCA FOLEY (EDD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:FOLEY
Last Name:MILLER
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 SESSIONS RD # 268
Mailing Address - Street 2:
Mailing Address - City:HARDWICK
Mailing Address - State:MA
Mailing Address - Zip Code:01037-9792
Mailing Address - Country:US
Mailing Address - Phone:508-954-5597
Mailing Address - Fax:
Practice Address - Street 1:242 OLD PETERSHAM RD
Practice Address - Street 2:
Practice Address - City:HARDWICK
Practice Address - State:MA
Practice Address - Zip Code:01037-9200
Practice Address - Country:US
Practice Address - Phone:413-477-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-01
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA462612103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool