Healthcare Provider Details

I. General information

NPI: 1801707690
Provider Name (Legal Business Name): REBECCA HOITASH PSYD, LEP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

148 LINDEN ST STE 104B
WELLESLEY MA
02482-7916
US

IV. Provider business mailing address

324 TREMONT ST
NEWTON MA
02458-2143
US

V. Phone/Fax

Practice location:
  • Phone: 617-299-9090
  • Fax:
Mailing address:
  • Phone: 617-299-9090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberLEP10000335
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: