Provider Demographics
NPI:1841754124
Name:HOGG, REBECCA DANIELLE (MA, LPC, RPT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:DANIELLE
Last Name:HOGG
Suffix:
Gender:F
Credentials:MA, LPC, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 E GRUBB DR, #852751
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75185-5130
Mailing Address - Country:US
Mailing Address - Phone:214-307-2340
Mailing Address - Fax:
Practice Address - Street 1:1401 N CENTRAL EXPY STE 120
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-4669
Practice Address - Country:US
Practice Address - Phone:214-307-2340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-30
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101YS0200X
TX74625101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool