Provider Demographics
NPI:1811265440
Name:AULD, REBEKAH HAYES
Entity type:Individual
Prefix:MRS
First Name:REBEKAH
Middle Name:HAYES
Last Name:AULD
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 1:59 MDW
Mailing Address - Street 2:1100 WILFORD HALL LOOP
Mailing Address - City:JBSA - LACKLAND AFB
Mailing Address - State:TX
Mailing Address - Zip Code:78236
Mailing Address - Country:US
Mailing Address - Phone:210-916-9900
Mailing Address - Fax:
Practice Address - Street 1:59 MDW
Practice Address - Street 2:1100 WILFORD HALL LOOP
Practice Address - City:JBSA - LACKLAND AFB
Practice Address - State:TX
Practice Address - Zip Code:78236
Practice Address - Country:US
Practice Address - Phone:210-916-9900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-09
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CT93931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program