Provider Demographics
NPI:1477065613
Name:FISCHER, REBECCA (MA)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:FISCHER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:297 THOUSAND OAKS DR
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:MA
Mailing Address - Zip Code:02631-2662
Mailing Address - Country:US
Mailing Address - Phone:508-785-5484
Mailing Address - Fax:
Practice Address - Street 1:297 THOUSAND OAKS DR
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:MA
Practice Address - Zip Code:02631-2662
Practice Address - Country:US
Practice Address - Phone:508-785-5484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-27
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No374J00000XNursing Service Related ProvidersDoula