Doctor Name: | MS. REBECCA LYNN SIDWELL-DOUGLAS |
NPI Number: | 1386844546 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 2005028054 |
Business Practice Address: | 14377 Woodlake Dr Suite 308 Chesterfield, MO - 630175735 |
Business Phone Number: | 3145766493 |
Business Fax Number: | 3145767319 |
Mailing Address: | 14377 Woodlake Dr, Suite 308 CHESTERFIELD |
State: | MO |
Postal Code: | 630175735 |
Phone Number: | 3145766493 |
Fax Number: | 3145767319 |
NPI Enumeration Date: | 07/24/2007 |
NPI Last Update Date: | 08/22/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 2005028054 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |