Healthcare Provider Details

I. General information

NPI: 1053155440
Provider Name (Legal Business Name): REBECCA DRUE HOVERMALE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2024
Last Update Date: 06/21/2024
Certification Date: 06/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

570 LINCOLN AVE
BELLEVUE PA
15202-3530
US

IV. Provider business mailing address

570 LINCOLN AVE
BELLEVUE PA
15202-3530
US

V. Phone/Fax

Practice location:
  • Phone: 412-223-7914
  • Fax:
Mailing address:
  • Phone: 412-223-7914
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPC00116
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: