Healthcare Provider Details

I. General information

NPI: 1043986128
Provider Name (Legal Business Name): REBECCA ANN ZILKOWSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2021
Last Update Date: 08/19/2021
Certification Date: 08/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 MAIN DUNSTABLE RD STE 200
NASHUA NH
03060-3640
US

IV. Provider business mailing address

81 BELLINGHAM ST APT 2
CHELSEA MA
02150-3201
US

V. Phone/Fax

Practice location:
  • Phone: 561-898-0096
  • Fax:
Mailing address:
  • Phone: 309-222-7918
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: