Provider Demographics
NPI:1972824134
Name:EILERS, REBECCA E (PHD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:E
Last Name:EILERS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 SEALIGHT LN
Mailing Address - Street 2:
Mailing Address - City:ROCKPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04856-4423
Mailing Address - Country:US
Mailing Address - Phone:207-236-0732
Mailing Address - Fax:207-230-1299
Practice Address - Street 1:91 CAMDEN ST
Practice Address - Street 2:SUITE 304
Practice Address - City:ROCKLAND
Practice Address - State:ME
Practice Address - Zip Code:04841-2455
Practice Address - Country:US
Practice Address - Phone:207-594-9786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-22
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPS 1286103TC0700X
MEPS1286103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical