Provider Demographics
NPI:1932949757
Name:MIEKLEY, REBECCA NICOLE (MS)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:NICOLE
Last Name:MIEKLEY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:119 ABBEYVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-3311
Mailing Address - Country:US
Mailing Address - Phone:215-913-5244
Mailing Address - Fax:
Practice Address - Street 1:1068 W BALTIMORE PIKE
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-5104
Practice Address - Country:US
Practice Address - Phone:484-227-9400
Practice Address - Fax:484-476-8151
Is Sole Proprietor?:No
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS