Provider Demographics
NPI:1649808742
Name:GAINER, REBECCA (CASE MANAGER)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:GAINER
Suffix:
Gender:F
Credentials:CASE MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 PLAZA DR STE M-O
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-8786
Mailing Address - Country:US
Mailing Address - Phone:740-449-2879
Mailing Address - Fax:
Practice Address - Street 1:107 PLAZA DR STE M-O
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-8786
Practice Address - Country:US
Practice Address - Phone:740-449-2879
Practice Address - Fax:740-449-2882
Is Sole Proprietor?:No
Enumeration Date:2020-04-01
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator