Provider Demographics
NPI:1326685223
Name:BAILEY, REBECCA CRISTINA (RBT-19-80567)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:CRISTINA
Last Name:BAILEY
Suffix:
Gender:F
Credentials:RBT-19-80567
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3422 TECKLA BLVD
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-4344
Mailing Address - Country:US
Mailing Address - Phone:405-397-2994
Mailing Address - Fax:
Practice Address - Street 1:6031 BELL ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-6618
Practice Address - Country:US
Practice Address - Phone:806-367-9358
Practice Address - Fax:806-500-2772
Is Sole Proprietor?:No
Enumeration Date:2019-12-10
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19-80567106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician