Provider Demographics
NPI:1063425411
Name:DEAL, REBECCA M (PHD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:M
Last Name:DEAL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:220 N WESTMONTE DR
Mailing Address - Street 2:SUITE E
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-3310
Mailing Address - Country:US
Mailing Address - Phone:407-862-5707
Mailing Address - Fax:407-862-5795
Practice Address - Street 1:220 N WESTMONTE DR
Practice Address - Street 2:SUITE E
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-3310
Practice Address - Country:US
Practice Address - Phone:407-862-5707
Practice Address - Fax:407-862-5795
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 2994103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL75778Medicare ID - Type UnspecifiedMEDICARE #