Provider Demographics
NPI:1528208220
Name:STEPHENS, REBECCA F (PHD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:F
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 FOOTHILLS PKWY
Mailing Address - Street 2:SUITE 215
Mailing Address - City:MARBLE HILL
Mailing Address - State:GA
Mailing Address - Zip Code:30148-2261
Mailing Address - Country:US
Mailing Address - Phone:770-893-3800
Mailing Address - Fax:
Practice Address - Street 1:25 FOOTHILLS PKWY
Practice Address - Street 2:SUITE 215
Practice Address - City:MARBLE HILL
Practice Address - State:GA
Practice Address - Zip Code:30148-2261
Practice Address - Country:US
Practice Address - Phone:770-893-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-20
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC001491101YP2500X
GAPSY002190103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional