Provider Demographics
NPI:1639849037
Name:ARNOLD, REBECCA SUSAN
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:SUSAN
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:SUSAN
Other - Last Name:CULPEPPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16200 AVERY RANCH BLVD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78717-4020
Mailing Address - Country:US
Mailing Address - Phone:512-704-0634
Mailing Address - Fax:
Practice Address - Street 1:16200 AVERY RANCH BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78717-4020
Practice Address - Country:US
Practice Address - Phone:512-704-0634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19570235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist