Provider Demographics
NPI:1871087270
Name:SCHNEIDER, REBECCA LYNN (PHD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:LYNN
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 ATHERTON ST APT 32
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-2647
Mailing Address - Country:US
Mailing Address - Phone:404-402-3377
Mailing Address - Fax:
Practice Address - Street 1:23 ISAAC ST
Practice Address - Street 2:
Practice Address - City:MIDDLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02346-2080
Practice Address - Country:US
Practice Address - Phone:404-402-3377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-19
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TC2200X
GAPSY004423103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent