Healthcare Provider Details

I. General information

NPI: 1740663285
Provider Name (Legal Business Name): REBECCA MARIE LIMBAUGH BSW, MA, LLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2015
Last Update Date: 07/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29300 POINTE O WOODS PL APT 107
SOUTHFIELD MI
48034-1238
US

IV. Provider business mailing address

29300 POINTE O WOODS PL APT 107
SOUTHFIELD MI
48034-1238
US

V. Phone/Fax

Practice location:
  • Phone: 248-342-9983
  • Fax:
Mailing address:
  • Phone: 248-342-9983
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number640101693
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: