Provider Demographics
NPI:1194134585
Name:EVANS FINK, REBECCA R
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:R
Last Name:EVANS FINK
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 1:50 W LAWN DR
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-5612
Mailing Address - Country:US
Mailing Address - Phone:201-833-2527
Mailing Address - Fax:
Practice Address - Street 1:50 W LAWN DR
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-5612
Practice Address - Country:US
Practice Address - Phone:201-833-2527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-11
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050792104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker