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General NPI Number Information
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NPI Number | 1376635094
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Entity Type | Organization
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Legal Business Name | REBECCA D BEAN BEHREND
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 464 DALY AVE #1
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City | WISCONSIN RAPIDS
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State | WI
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Zip | 54494-4746
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Country | US
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Telephone | 175-423-2030
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Fax | 715-423-2032
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Provider Business Mailing Address
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Address Line | 464 DALY AVE #1
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City | WISCONSIN RAPIDS
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State | WI
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Zip | 54494-4746
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Country | US
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Telephone | 175-423-2030
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Fax | 715-423-2032
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Authorized Official
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Title or Position | ADMINISTRATIVE ASSISTANT
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Name | DEBORAH S FUEHRER
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Credential | BSW
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Telephone | 715-423-2030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 2352
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License Number State | WI
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