Doctor Name: | REBBECCA ANN WELLBORN |
NPI Number: | 1134328131 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 2434-C |
Business Practice Address: | 2305 Old County Road Pocahontas, AR - 724554148 |
Business Phone Number: | 8708921005 |
Business Fax Number: | 8708920078 |
Mailing Address: | 1815 Pleasant Grove Road, JONESBORO |
State: | AR |
Postal Code: | 724017870 |
Phone Number: | 8709336886 |
Fax Number: | 8709339395 |
NPI Enumeration Date: | 07/11/2007 |
NPI Last Update Date: | 02/24/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 2434-C |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |