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General NPI Number Information
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NPI Number | 1023160546
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Entity Type | Individual
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Provider Name | WENDY REBERT PH.D.
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Gender | Female
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 01/31/2018
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Provider Practice Location Address
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Address Line | 1109 SPRING DR
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City | OPELIKA
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State | AL
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Zip | 36801-5345
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Country | US
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Telephone | 334-745-2760
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Fax | 334-745-7998
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Provider Business Mailing Address
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Address Line | 2020 PEACHTREE RD NW
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City | ATLANTA
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State | GA
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Zip | 30309-1426
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Country | US
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Telephone | 404-350-7323
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Fax | 404-350-7694
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY002491
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 550
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License Number State | AL
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