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General NPI Number Information
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NPI Number | 1679627277
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Entity Type | Individual
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Provider Name | REBECCA A JEFFERS LPC
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Gender | Female
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 08/25/2010
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Provider Practice Location Address
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Address Line | 4200 S HULEN ST STE 662
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City | FORT WORTH
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State | TX
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Zip | 76109-4997
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Country | US
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Telephone | 817-219-7913
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Fax | 817-886-8616
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Provider Business Mailing Address
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Address Line | 7308 OLD MILL RUN ST
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City | FORT WORTH
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State | TX
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Zip | 76133-7025
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Country | US
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Telephone | 817-219-7913
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 16069
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License Number State | TX
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