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General NPI Number Information
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NPI Number | 1134900053
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Entity Type | Organization
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Legal Business Name | REBECCA V. DEGRAAF LLC
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Dates
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Enumeration Date | 10/06/2023
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Last Update Date | 10/06/2023
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Provider Practice Location Address
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Address Line | 3610 BUTTONWOOD DR STE 200
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City | COLUMBIA
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State | MO
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Zip | 65201-3721
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Country | US
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Telephone | 573-886-8982
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Fax | 573-886-8901
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Provider Business Mailing Address
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Address Line | 3610 BUTTONWOOD DR STE 200
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City | COLUMBIA
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State | MO
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Zip | 65201-3721
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Country | US
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Telephone | 573-886-8982
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Fax | 573-886-8901
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST
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Name | REBECCA V DEGRAAF
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Credential | PH.D.
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Telephone | 573-886-8982
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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