Provider Demographics
NPI:1285115733
Name:PALMER, REBEKAH ANN (BEHAVIOR TECHNICIAN)
Entity type:Individual
Prefix:
First Name:REBEKAH
Middle Name:ANN
Last Name:PALMER
Suffix:
Gender:F
Credentials:BEHAVIOR TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 MARGO ST
Mailing Address - Street 2:
Mailing Address - City:TAWAS CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48763-9223
Mailing Address - Country:US
Mailing Address - Phone:989-984-9712
Mailing Address - Fax:
Practice Address - Street 1:300 MARGO ST
Practice Address - Street 2:
Practice Address - City:TAWAS CITY
Practice Address - State:MI
Practice Address - Zip Code:48763-9223
Practice Address - Country:US
Practice Address - Phone:989-984-9712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician