Provider Demographics
NPI:1013186089
Name:SNEED-MATTHEWS, REBECCA V
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:V
Last Name:SNEED-MATTHEWS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2620 CENTENARY BLVD
Mailing Address - Street 2:BLDG. 1 SUITE 104
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71104-3356
Mailing Address - Country:US
Mailing Address - Phone:318-213-2273
Mailing Address - Fax:318-213-2275
Practice Address - Street 1:2620 CENTENARY BLVD
Practice Address - Street 2:BLDG. 1 SUITE 104
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71104-3356
Practice Address - Country:US
Practice Address - Phone:318-213-2273
Practice Address - Fax:318-213-2275
Is Sole Proprietor?:No
Enumeration Date:2008-02-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator