Basic Information
| Provider Information | |||||||||
| NPI: | 1083143143 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FURROW | ||||||||
| FirstName: | REBECCA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 82 | ||||||||
| Address2: | |||||||||
| City: | FREEDOM | ||||||||
| State: | ME | ||||||||
| PostalCode: | 049410082 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2073826059 | ||||||||
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| Practice Location | |||||||||
| Address1: | 32 COLLEGE AVE | ||||||||
| Address2: | |||||||||
| City: | WATERVILLE | ||||||||
| State: | ME | ||||||||
| PostalCode: | 049016100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2076802065 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2017 | ||||||||
| LastUpdateDate: | 06/12/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | ME | N | Behavioral Health & Social Service Providers | Counselor | Professional | 101YP2500X | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.