Basic Information
| Provider Information | |||||||||
| NPI: | 1811391642 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | REBH | ||||||||
| FirstName: | ADAM | ||||||||
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| Credential: | PCC-SUPV | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5982 RHODES ROAD | ||||||||
| Address2: | |||||||||
| City: | KENT | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44240 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3306731347 | ||||||||
| FaxNumber: | 3306783677 | ||||||||
| Practice Location | |||||||||
| Address1: | 1410 W. STATE STREET | ||||||||
| Address2: | |||||||||
| City: | ALLIANCE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3308236932 | ||||||||
| FaxNumber: | 3306783677 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/22/2014 | ||||||||
| LastUpdateDate: | 10/22/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | E.0700205-SUPV | OH | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.