Provider Demographics
NPI:1881477230
Name:SAINT ELOI, REBECCA NAOMI (MS)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:NAOMI
Last Name:SAINT ELOI
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 S FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-2619
Mailing Address - Country:US
Mailing Address - Phone:954-728-1083
Mailing Address - Fax:954-779-2316
Practice Address - Street 1:1401 S FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-2619
Practice Address - Country:US
Practice Address - Phone:954-728-1083
Practice Address - Fax:954-779-2316
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-17
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X, 106S00000X
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No104100000XBehavioral Health & Social Service ProvidersSocial Worker