| Doctor Name: | REBECCA AVERY |
| NPI Number: | 1699155176 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S. ED, CAS |
| License Number: | 942750151 |
| Business Practice Address: | 2841 Thousand Acres Rd Delanson, NY - 120531917 |
| Business Phone Number: | 5188756141 |
| Business Fax Number: | |
| Mailing Address: | 2841 Thousand Acres Rd, DELANSON |
| State: | NY |
| Postal Code: | 120531917 |
| Phone Number: | 5188756141 |
| Fax Number: | |
| NPI Enumeration Date: | 06/01/2015 |
| NPI Last Update Date: | 06/01/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TS0200X |
| License Number: | 942750151 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |