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General NPI Number Information
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NPI Number | 1457484768
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Entity Type | Individual
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Provider Name | CONSTANCE ELEANOR REBICH PH.D.
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Gender | Female
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 23875 COMMERCE PARK SUITE 130
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City | BEACHWOOD
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State | OH
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Zip | 44122-5805
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Country | US
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Telephone | 216-556-5062
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Fax | 216-464-4693
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Provider Business Mailing Address
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Address Line | 2919 FRAMINGHAM LN
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City | TWINSBURG
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State | OH
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Zip | 44087-2934
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Country | US
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Telephone | 330-405-1354
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Fax | 216-464-4693
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 3146
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License Number State | OH
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