Provider Demographics
NPI:1609414705
Name:WONDERLEY, REBECCA YVONNE (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:YVONNE
Last Name:WONDERLEY
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 STONERIDGE DR STE A03
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:VA
Mailing Address - Zip Code:22980-6582
Mailing Address - Country:US
Mailing Address - Phone:540-471-0569
Mailing Address - Fax:
Practice Address - Street 1:25 STONERIDGE DR
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:VA
Practice Address - Zip Code:22980-6582
Practice Address - Country:US
Practice Address - Phone:540-471-0569
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-19
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701008854101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional