Provider Information for 1205597234
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REBECCA ROARK MSW, LCSW
Sex: Female
NPI: 1205597234
Last Updated: 2022-01-03
Certification Date: 2022-01-03
Certification Date: 2022-01-03
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1205597234 | ||||||||||||
| Enumeration Date | 2022-01-03 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 3367 SUPERIOR PARK DR CLEVELAND HEIGHTS, OH 44118-2105 United States Phone: 216-315-0893 | Fax: | ||||||||||||
| Primary Practice Address | 3367 SUPERIOR PARK DR CLEVELAND HEIGHTS, OH 44118-2105 United States Phone: 216-315-0893 | Fax: | ||||||||||||
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