Doctor Name: | MS. REBECCA GREATHOUSE WREN |
NPI Number: | 1851692321 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.ED., LPCS, LSOTP-S |
License Number: | 9061 |
Business Practice Address: | 107 Deer Ridge Dr Fort Davis, TX - 797342507 |
Business Phone Number: | 4324269034 |
Business Fax Number: | |
Mailing Address: | Hc 75 Box 203, FORT DAVIS |
State: | TX |
Postal Code: | 797345013 |
Phone Number: | 4324269034 |
Fax Number: | |
NPI Enumeration Date: | 11/15/2010 |
NPI Last Update Date: | 11/15/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 9061 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |