Provider Demographics
NPI:1922284330
Name:CUBBERLY, REBECCA DAWSON (PHD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:DAWSON
Last Name:CUBBERLY
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 1:3024 CHEVY CHASE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77019-3206
Mailing Address - Country:US
Mailing Address - Phone:713-528-4020
Mailing Address - Fax:
Practice Address - Street 1:1720 SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-1714
Practice Address - Country:US
Practice Address - Phone:713-528-4020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-15
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8766101YP2500X
TX000541106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional