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General NPI Number Information
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NPI Number | 1932190709
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Entity Type | Individual
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Provider Name | REBECCA LYNN MOBERLY PHD
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Gender | Female
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Dates
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Enumeration Date | 11/02/2005
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Last Update Date | 03/29/2019
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Provider Practice Location Address
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Address Line | 4101 SOUTH 4TH STREET TRAFFICWAY WOMEN'S HEALTH CENTER
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City | LEAVENWORTH
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State | KS
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Zip | 66048-5104
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Country | US
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Telephone | 913-682-2000
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Fax | 913-946-1572
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Provider Business Mailing Address
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Address Line | 4101 SOUTH 4TH STREET TRAFFICWAY WOMEN'S HEALTH CENTER
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City | LEAVENWORTH
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State | KS
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Zip | 66048-5014
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Country | US
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Telephone | 913-682-2000
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Fax | 913-946-1572
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 2017041076
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License Number State | MO
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