Provider Demographics
NPI:1063915585
Name:MEYER, REBECCA B
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:B
Last Name:MEYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12975 EMERSON AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-2816
Mailing Address - Country:US
Mailing Address - Phone:330-703-7244
Mailing Address - Fax:
Practice Address - Street 1:2114 NOBLE RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44112-1725
Practice Address - Country:US
Practice Address - Phone:216-268-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-11
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No171M00000XOther Service ProvidersCase Manager/Care Coordinator