Provider Demographics
NPI:1265750020
Name:PENDER, REBEKAH RUTH (PHD, LPC, NCC)
Entity type:Individual
Prefix:DR
First Name:REBEKAH
Middle Name:RUTH
Last Name:PENDER
Suffix:
Gender:F
Credentials:PHD, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11300 EXPO BLVD
Mailing Address - Street 2:APT. 2218
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-1005
Mailing Address - Country:US
Mailing Address - Phone:210-557-9484
Mailing Address - Fax:
Practice Address - Street 1:535 BANDERA RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78228-5524
Practice Address - Country:US
Practice Address - Phone:210-431-6466
Practice Address - Fax:210-431-6470
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-04
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61552101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health