Provider Demographics
NPI:1770896789
Name:RIOS, REBECA (PHD)
Entity type:Individual
Prefix:
First Name:REBECA
Middle Name:
Last Name:RIOS
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 1:7211 16TH AVE
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-7045
Mailing Address - Country:US
Mailing Address - Phone:443-449-3715
Mailing Address - Fax:
Practice Address - Street 1:8630 FENTON ST STE 328
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3816
Practice Address - Country:US
Practice Address - Phone:301-965-0284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-19
Last Update Date:2021-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY1001320103T00000X
103T00000X
MD05007103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist