Provider Demographics
NPI:1295353449
Name:LABREW, RITA (MASTERS OF SCIENCE)
Entity type:Individual
Prefix:MS
First Name:RITA
Middle Name:
Last Name:LABREW
Suffix:
Gender:F
Credentials:MASTERS OF SCIENCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 BENCHLEY PL APT 10A
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-3537
Mailing Address - Country:US
Mailing Address - Phone:917-689-8379
Mailing Address - Fax:
Practice Address - Street 1:310 SAINT NICHOLAS AVE STE 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237-6568
Practice Address - Country:US
Practice Address - Phone:929-296-6790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-13
Last Update Date:2023-08-26
Deactivation Date:2021-07-12
Deactivation Code:
Reactivation Date:2023-08-21
Provider Licenses
StateLicense IDTaxonomies
NYP107126106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist