Doctor Name: | MRS. REBECCA ANN TRUST |
NPI Number: | 1851650048 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS |
License Number: | |
Business Practice Address: | 247 Valley Dr Cornelia, GA - 305312287 |
Business Phone Number: | 7705408834 |
Business Fax Number: | |
Mailing Address: | 247 Valley Dr, CORNELIA |
State: | GA |
Postal Code: | 305312287 |
Phone Number: | 7705408834 |
Fax Number: | |
NPI Enumeration Date: | 05/09/2012 |
NPI Last Update Date: | 05/09/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |