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General NPI Number Information
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NPI Number | 1093001505
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Entity Type | Individual
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Provider Name | REBECCA LEIGH EVERETT M.S., BCBA
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Gender | Female
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Dates
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Enumeration Date | 06/22/2011
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Last Update Date | 05/07/2020
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Provider Practice Location Address
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Address Line | 207 COLUMBUS ST
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City | PANAMA CITY BEACH
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State | FL
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Zip | 32407-1200
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Country | US
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Telephone | 931-303-2630
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Fax |
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Provider Business Mailing Address
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Address Line | 207 COLUMBUS ST
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City | PANAMA CITY BEACH
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State | FL
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Zip | 32407-1200
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Country | US
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Telephone | 931-303-2630
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | LBA0000000179
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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