Provider Demographics
NPI:1841700838
Name:ROCK, REBECCA SARAH MARIANNE (PSYD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:SARAH MARIANNE
Last Name:ROCK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38010 14TH AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-3459
Mailing Address - Country:US
Mailing Address - Phone:407-450-3865
Mailing Address - Fax:
Practice Address - Street 1:2739 GALL BLVD
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33541-9701
Practice Address - Country:US
Practice Address - Phone:813-780-3190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-04
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS56997103T00000X
FLPY9739103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist