Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 57.012241 | OK |
NPI | 1174734461 |
---|---|
Provider Name | Dr. Rebecca Lynn Rakow Flyckt |
First Address | Cleveland Heights, OH 44118-3528 |
Second Address | Cleveland, OH 44106-1716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2007 |
Last Update Date | 21/12/2020 |