Provider Demographics
NPI:1942663174
Name:FAULKNER, REBECCA (MT-BC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:FAULKNER
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12600 AVERY RANCH BLVD
Mailing Address - Street 2:APT 1821
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-1690
Mailing Address - Country:US
Mailing Address - Phone:512-923-0317
Mailing Address - Fax:
Practice Address - Street 1:12600 AVERY RANCH BLVD
Practice Address - Street 2:APT 1821
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-1690
Practice Address - Country:US
Practice Address - Phone:512-923-0317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-04
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist