Healthcare Provider Details

I. General information

NPI: 1245833516
Provider Name (Legal Business Name): REBECCA VIL VIL JEAN-BAPTISTE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/19/2020
Last Update Date: 11/19/2020
Certification Date: 11/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

164-37 144 ROAD
JAMAICA NY
11434
US

IV. Provider business mailing address

585 E 32ND ST APT D2
BROOKLYN NY
11210-2605
US

V. Phone/Fax

Practice location:
  • Phone: 718-978-7221
  • Fax: 718-978-0032
Mailing address:
  • Phone: 917-213-8547
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: