Provider Demographics
NPI:1053794313
Name:DOPP, REBECKAH (MA SPED MS BCBA)
Entity type:Individual
Prefix:
First Name:REBECKAH
Middle Name:
Last Name:DOPP
Suffix:
Gender:F
Credentials:MA SPED MS BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 VULCO DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-4819
Mailing Address - Country:US
Mailing Address - Phone:615-828-5040
Mailing Address - Fax:
Practice Address - Street 1:105 VULCO DR
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-4819
Practice Address - Country:US
Practice Address - Phone:615-828-5040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-06
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst