Individual
REBECCA LOUISE NEILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS, QDDP, MHRT/C
Contact information
Practice address
630 HOFSTADTER RD STE 125, NEWPORT NEWS, VA 23606-3066
(757) 969-8669
(757) 401-4527
Mailing address
630 HOFSTADTER RD STE 125, NEWPORT NEWS, VA 23606-3066
(757) 969-8669
(757) 401-4527
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0832730383
—
VA
Enumeration date
11/07/2019
Last updated
11/07/2019
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