Provider Demographics
NPI:1023985124
Name:WALLINGFORD, REBECCA STEELE
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:STEELE
Last Name:WALLINGFORD
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 1:425 POPO AGIE ST
Mailing Address - Street 2:
Mailing Address - City:LANDER
Mailing Address - State:WY
Mailing Address - Zip Code:82520-3341
Mailing Address - Country:US
Mailing Address - Phone:606-584-3765
Mailing Address - Fax:
Practice Address - Street 1:425 POPO AGIE ST
Practice Address - Street 2:
Practice Address - City:LANDER
Practice Address - State:WY
Practice Address - Zip Code:82520-3341
Practice Address - Country:US
Practice Address - Phone:606-584-3765
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-22
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker