Provider Demographics
NPI:1932113990
Name:CLICK, REBECCA DYAN (MA, BCBA)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:DYAN
Last Name:CLICK
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2032 CARL MEARES RD
Mailing Address - Street 2:
Mailing Address - City:FAIR BLUFF
Mailing Address - State:NC
Mailing Address - Zip Code:28439-9787
Mailing Address - Country:US
Mailing Address - Phone:910-840-5998
Mailing Address - Fax:910-313-6598
Practice Address - Street 1:2032 CARL MEARES RD
Practice Address - Street 2:
Practice Address - City:FAIR BLUFF
Practice Address - State:NC
Practice Address - Zip Code:28439-9787
Practice Address - Country:US
Practice Address - Phone:910-840-5998
Practice Address - Fax:910-313-6598
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst