Healthcare Provider Details

I. General information

NPI: 1497881460
Provider Name (Legal Business Name): REBECCA ANNA VIETH-ALBRECHT LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416 REDWOOD DR
NEW BLOOMFIELD MO
65063-5418
US

IV. Provider business mailing address

416 REDWOOD DR
NEW BLOOMFIELD MO
65063-5418
US

V. Phone/Fax

Practice location:
  • Phone: 573-462-9300
  • Fax:
Mailing address:
  • Phone: 573-462-9300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2003001468
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: