MEDICARE: REBEKAH VEPRASKAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	LPC007322	GA

General Provider Information

NPI Number	:	1720530900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBEKAH VEPRASKAS

Provider Business Mailing Address
First Line	:	912 E PONCE DE LEON AVE
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30030-2708
Country	:	US
Telephone Number	:	404-373-4087
Fax Number	:	404-373-4087

Provider Business Practice Location Address
First Line	:	912 E PONCE DE LEON AVE
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30030-2708
Country	:	US
Telephone Number	:	404-373-4087
Fax Number	:	404-373-4087

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2016
Last Update Date	:	11/03/2016

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Directions to “ REBEKAH VEPRASKAS ” Practice Location

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