Doctor Name: | REBECCA MARY EAVES |
NPI Number: | 1376724690 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CADC |
License Number: | |
Business Practice Address: | 5409 Avenue O Fort Madison, IA - 526279601 |
Business Phone Number: | 3193762134 |
Business Fax Number: | 3193762188 |
Mailing Address: | 5409 Avenue O, FORT MADISON |
State: | IA |
Postal Code: | 526279601 |
Phone Number: | 3193762134 |
Fax Number: | 3193762188 |
NPI Enumeration Date: | 11/15/2007 |
NPI Last Update Date: | 11/15/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |