Provider Demographics
NPI:1174105324
Name:REBEYKA, ALEXIS E (NMD)
Entity type:Individual
Prefix:DR
First Name:ALEXIS
Middle Name:E
Last Name:REBEYKA
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3305 E GREENWAY RD STE 7
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-4509
Mailing Address - Country:US
Mailing Address - Phone:480-903-8346
Mailing Address - Fax:480-841-5024
Practice Address - Street 1:3305 E GREENWAY RD STE 7
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-4509
Practice Address - Country:US
Practice Address - Phone:480-903-8346
Practice Address - Fax:480-841-5024
Is Sole Proprietor?:No
Enumeration Date:2021-04-27
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ20-1944175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath