Basic Information
| Provider Information | |||||||||
| NPI: | 1245999275 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCDERMOTT | ||||||||
| FirstName: | REBECCA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1400 SLEEPY HOLLOW RD | ||||||||
| Address2: | |||||||||
| City: | CHRISTIANSBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 240737608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3159259216 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2900 LAMB CIR | ||||||||
| Address2: | |||||||||
| City: | CHRISTIANSBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 240736344 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5407312000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/17/2021 | ||||||||
| LastUpdateDate: | 12/17/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/17/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 0810007556 | VA | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.