MEDICARE: REBEKAH JO ANN METZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker
2	104100000X	Social Worker

General Provider Information

NPI Number	:	1225481732
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBEKAH JO ANN METZ

Provider Business Mailing Address
First Line	:	1430 OLIVE ST STE 400
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63103-2303
Country	:	US
Telephone Number	:	573-760-8360
Fax Number	:	314-206-3700

Provider Business Practice Location Address
First Line	:	657 WALTON DR
Second Line	:
City	:	FARMINGTON
State	:	MO
Zip	:	63640-1935
Country	:	US
Telephone Number	:	573-760-8360
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2016
Last Update Date	:	12/03/2019

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Directions to “ REBEKAH JO ANN METZ ” Practice Location

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