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Individual
REBECCA L DESSERTINE
Active
Individual
REBECCA L DESSERTINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
122778
MA
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
122778
DIVISION OF PROFESSIONAL LICENSURE
MA
Enumeration date
09/28/2015
Last updated
02/03/2023
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