Provider Demographics
NPI:1578362679
Name:DEMETERCO, REBECA
Entity type:Individual
Prefix:
First Name:REBECA
Middle Name:
Last Name:DEMETERCO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 24TH ST NW APT 612
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-2276
Mailing Address - Country:US
Mailing Address - Phone:202-704-5059
Mailing Address - Fax:
Practice Address - Street 1:1517 18TH ST NW FL 4
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-1305
Practice Address - Country:US
Practice Address - Phone:202-308-9690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist