Provider Demographics
NPI:1053881946
Name:ALLEN, REBECCA L
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:L
Last Name:ALLEN
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 1:4 NEW HAVEN CT
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:OH
Mailing Address - Zip Code:45030-9754
Mailing Address - Country:US
Mailing Address - Phone:513-641-0737
Mailing Address - Fax:
Practice Address - Street 1:4 NEW HAVEN CT
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:OH
Practice Address - Zip Code:45030-9754
Practice Address - Country:US
Practice Address - Phone:513-614-0737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-04
Last Update Date:2024-03-09
Deactivation Date:2024-03-04
Deactivation Code:
Reactivation Date:2024-03-08
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator