Provider Demographics
NPI:1932416237
Name:FANCHER, REBECCA CHOATE (MS, LPC)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:CHOATE
Last Name:FANCHER
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:MS
Other - First Name:REBECCA
Other - Middle Name:ANN
Other - Last Name:CHOATE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:304 SE EATON ST
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-3923
Mailing Address - Country:US
Mailing Address - Phone:314-703-9313
Mailing Address - Fax:479-250-9887
Practice Address - Street 1:304 SE EATON ST
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-3923
Practice Address - Country:US
Practice Address - Phone:314-703-9313
Practice Address - Fax:479-250-9887
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1707331101YM0800X
OK5511101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health