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NPI Code Detail

MEDICARE: REBECCA ROSE LIPSETT

MEDICARE: REBECCA ROSE LIPSETT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianRBT-18-70886GA

General Provider Information

NPI Number : 1639649569
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA ROSE LIPSETT
Provider Business Mailing Address
First Line : 3771 STEFANI RD
Second Line :
City : CANTONMENT
State : FL
Zip : 32533-7795
Country : US
Telephone Number : 850-670-6910
Fax Number : 850-607-6932
Provider Business Practice Location Address
First Line : 5900 WARM SPRINGS RD STE J
Second Line :
City : COLUMBUS
State : GA
Zip : 31909-4597
Country : US
Telephone Number : 850-607-6910
Fax Number : 850-607-6932
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2018
Last Update Date : 12/04/2018

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Directions to “ REBECCA ROSE LIPSETT ” Practice Location

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