| Doctor Name: | DR. REBECCA MELODY LEIB |
| NPI Number: | 1770659906 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | 22164 |
| Business Practice Address: | 6216a Highway 9 Felton, CA - 950189713 |
| Business Phone Number: | 8314195699 |
| Business Fax Number: | |
| Mailing Address: | 6216a Highway 9, FELTON |
| State: | CA |
| Postal Code: | 950189713 |
| Phone Number: | 8314195699 |
| Fax Number: | |
| NPI Enumeration Date: | 11/28/2006 |
| NPI Last Update Date: | 01/13/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC2200X |
| License Number: | 22164 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical Child & Adolescent |
| Taxonomy Definition: | |