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NPI Code Detail

MEDICARE: REBECCA ANN SHEREN BEHAVIOR TECHNICIAN

MEDICARE: REBECCA ANN SHEREN BEHAVIOR TECHNICIAN
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 Technician
2224Z00000XOccupational Therapy Assistant5202006239MI

General Provider Information

NPI Number : 1700152469
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA ANN SHEREN BEHAVIOR TECHNICIAN
Provider Business Mailing Address
First Line : 1500 S DOUGLAS RD STE 230
Second Line :
City : CORAL GABLES
State : FL
Zip : 33134-4108
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 31557 SCHOOLCRAFT RD STE 200
Second Line :
City : LIVONIA
State : MI
Zip : 48150-1848
Country : US
Telephone Number : 734-530-3907
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2012
Last Update Date : 12/08/2022

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