Provider Demographics
NPI:1932680972
Name:REES, REBECCA JANE
Entity Type:Individual
Prefix:PROF
First Name:REBECCA
Middle Name:JANE
Last Name:REES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 COUNTY ROAD 118
Mailing Address - Street 2:
Mailing Address - City:SWEETWATER
Mailing Address - State:TX
Mailing Address - Zip Code:79556-3652
Mailing Address - Country:US
Mailing Address - Phone:325-338-1588
Mailing Address - Fax:
Practice Address - Street 1:808 1/2 EAST BROADWAY
Practice Address - Street 2:
Practice Address - City:SWEETWATER
Practice Address - State:TX
Practice Address - Zip Code:79556
Practice Address - Country:US
Practice Address - Phone:325-338-1588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-28
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX74616101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional