MEDICARE: DR. DEBRA LYNN REBLE PH.D.

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
1	103T00000X	Psychologist	5004	OH

General Provider Information

NPI Number	:	1750590758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBRA LYNN REBLE PH.D.

Provider Business Mailing Address
First Line	:	2702 SCARBOROUGH RD
Second Line	:
City	:	CLEVELAND HTS
State	:	OH
Zip	:	44106-3628
Country	:	US
Telephone Number	:	216-320-0160
Fax Number	:

Provider Business Practice Location Address
First Line	:	2702 SCARBOROUGH RD
Second Line	:
City	:	CLEVELAND HTS
State	:	OH
Zip	:	44106-3628
Country	:	US
Telephone Number	:	216-320-0160
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2007
Last Update Date	:	07/08/2007

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