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General NPI Number Information
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NPI Number | 1598628125
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Entity Type | Individual
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Provider Name | LISA VAIL-REBELSKY
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Gender | Female
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Dates
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Enumeration Date | 12/09/2025
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 2501 CHATHAM RD STE R
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City | SPRINGFIELD
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State | IL
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Zip | 62704-4188
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Country | US
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Telephone | 415-322-8857
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Fax |
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Provider Business Mailing Address
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Address Line | 440 N BARRANCA AVE # 9605
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City | COVINA
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State | CA
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Zip | 91723-1722
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-24-334835
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License Number State | IL
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