Provider Demographics
NPI:1912161068
Name:RICHMOND, REBECCA ANN (PSYD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANN
Last Name:RICHMOND
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 1:262 CHAPMAN ROAD
Mailing Address - Street 2:SUITE 100, THE BELLEVUE BUILDING
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-5412
Mailing Address - Country:US
Mailing Address - Phone:302-292-0888
Mailing Address - Fax:302-292-0889
Practice Address - Street 1:262 CHAPMAN ROAD
Practice Address - Street 2:SUITE 100, THE BELLEVUE BUILDING
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5412
Practice Address - Country:US
Practice Address - Phone:302-292-0888
Practice Address - Fax:302-292-0889
Is Sole Proprietor?:No
Enumeration Date:2008-07-17
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEB1-0000789103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical