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NPI 1154481679

NPI 1154481679 : REBECCA YODER ADLER LICSW : NEWBURYPORT, MA

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General NPI Number Information
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    NPI Number           |    1154481679
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    Entity Type          |    Individual 
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    Provider Name        |    REBECCA YODER ADLER LICSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/12/2006
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    Last Update Date     |    11/08/2011
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Provider Practice Location Address
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    Address Line         |    1 MERRIMAC STREET SUITE 17
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    City                 |    NEWBURYPORT
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    State                |    MA
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    Zip                  |    01950
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    Country              |    US
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    Telephone            |    978-463-3030
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    Fax                  |    978-463-0009
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Provider Business Mailing Address
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    Address Line         |    1 MERRIMAC STREET SUITE 17
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    City                 |    NEWBURYPORT
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    State                |    MA
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    Zip                  |    01950
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    Country              |    US
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    Telephone            |    978-465-7900
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    Fax                  |    978-463-0009
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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        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    101614
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    License Number State |    MA
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