Provider Demographics
NPI:1356814800
Name:DOLL, REBECCA
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:DOLL
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 1:2417 WILCOX DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-3956
Mailing Address - Country:US
Mailing Address - Phone:210-710-8662
Mailing Address - Fax:
Practice Address - Street 1:2009 BOSC DR
Practice Address - Street 2:
Practice Address - City:NEWCASTLE
Practice Address - State:OK
Practice Address - Zip Code:73065-6652
Practice Address - Country:US
Practice Address - Phone:405-757-0662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-08
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health