Provider Demographics
NPI:1295858785
Name:KNEUPPER, REBECCA (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:
Last Name:KNEUPPER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 REBECCA RD
Mailing Address - Street 2:
Mailing Address - City:BANDERA
Mailing Address - State:TX
Mailing Address - Zip Code:78003-3892
Mailing Address - Country:US
Mailing Address - Phone:830-796-3999
Mailing Address - Fax:
Practice Address - Street 1:411 REBECCA RD
Practice Address - Street 2:
Practice Address - City:BANDERA
Practice Address - State:TX
Practice Address - Zip Code:78003-3892
Practice Address - Country:US
Practice Address - Phone:830-796-3999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13471101YP2500X
TX004700042563106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist