Provider Demographics
NPI:1124273040
Name:O'CONNOR, REBECCA ANN (MA)
Entity type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:ANN
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 PERSEVERANCE WAY
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-1843
Mailing Address - Country:US
Mailing Address - Phone:508-815-5146
Mailing Address - Fax:508-862-0590
Practice Address - Street 1:60 PERSEVERANCE WAY
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-1843
Practice Address - Country:US
Practice Address - Phone:508-815-5146
Practice Address - Fax:508-862-0590
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-19
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor