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General NPI Number Information
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NPI Number | 1396103297
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Entity Type | Individual
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Provider Name | REBECCA HERTENSTEIN
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Gender | Female
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Dates
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Enumeration Date | 02/05/2016
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Last Update Date | 03/10/2016
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Provider Practice Location Address
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Address Line | 14572 US HIGHWAY 23
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City | WAVERLY
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State | OH
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Zip | 45690-9373
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Country | US
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Telephone | 740-947-5774
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Fax |
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Provider Business Mailing Address
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Address Line | 382 S MCARTHUR ST
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City | CHILLICOTHEE
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State | OH
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Zip | 45601-3627
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Country | US
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Telephone |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 151154
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License Number State | OH
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