Healthcare Provider Details

I. General information

NPI: 1366610578
Provider Name (Legal Business Name): REBECCA D DOLL M.A. CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REBECCA JOHNSON M.A. CCC-A

II. Dates (important events)

Enumeration Date: 02/11/2008
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 DUKE MEDICINE CIR CLINIC 1-I
DURHAM NC
27710-0001
US

IV. Provider business mailing address

BOX 3887 - DUMC
DURHAM NC
27710-0001
US

V. Phone/Fax

Practice location:
  • Phone: 919-684-3451
  • Fax:
Mailing address:
  • Phone: 919-684-6271
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number4857
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number1310
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: