Divico, Rebecca Lynn
Divico, Rebecca Lynn is an sole proprietor health care provider with primary practice located at 200 N Main St Ste 17 , East Longmeadow MA 01028-2354. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Divico, Rebecca Lynn can be contacted via phone (413) 209-7796.Contact Information
Primary practice address
200 N Main St Ste 17
East Longmeadow MA 01028-2354
Phone: (413) 209-7796
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 12081 | Massachusetts |
Profile Details
| NPI number | 1457879942 |
|---|---|
| LBN Legal business name | Divico, Rebecca Lynn |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 5th, 2017 |
| Last updated | Apr 6th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457879942 | NPPES |
| Massachusetts | MEDICAID | 042680339 |
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