Healthcare Provider Details
I. General information
NPI: 1790219426
Provider Name (Legal Business Name): REBECKA E TOMPKINS PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/19/2017
Last Update Date: 07/10/2024
Certification Date: 07/10/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13460 WALSH DR
BOYS TOWN NE
68010-7529
US
IV. Provider business mailing address
13460 WALSH DR
BOYS TOWN NE
68010-7529
US
V. Phone/Fax
- Phone: 531-355-3358
- Fax: 531-355-3375
- Phone: 531-355-3358
- Fax: 531-355-3375
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | 086957 |
| License Number State | IA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | 843 |
| License Number State | NE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: