Provider Demographics
NPI:1134552979
Name:SUFFNESS, REBECCA AUGUSTE (PHD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:AUGUSTE
Last Name:SUFFNESS
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 1:205 WILD BASIN RD S #3
Mailing Address - Street 2:SUITE 202
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746
Mailing Address - Country:US
Mailing Address - Phone:512-246-7225
Mailing Address - Fax:512-879-9577
Practice Address - Street 1:205 WILD BASIN RD S #3
Practice Address - Street 2:SUITE 202
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746
Practice Address - Country:US
Practice Address - Phone:512-246-7225
Practice Address - Fax:512-879-9577
Is Sole Proprietor?:No
Enumeration Date:2013-08-15
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4830103TC0700X
TX38044103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical