Basic Information
Provider Information
NPI: 1679816797
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RABBITT
FirstName: BETTE
MiddleName: LEE
NamePrefix: MS.
NameSuffix:  
Credential: LPC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3350 COLLINGWOOD BLVD
Address2:  
City: TOLEDO
State: OH
PostalCode: 436101173
CountryCode: US
TelephoneNumber: 4192559585
FaxNumber:  
Practice Location
Address1: 3350 COLLINGWOOD BLVD
Address2:  
City: TOLEDO
State: OH
PostalCode: 436101173
CountryCode: US
TelephoneNumber: 4192559585
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/27/2013
LastUpdateDate: 03/27/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800XC0017409OHY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


Home