MEDICARE: REBECKA SMITH BCBA, LBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	7949	TX

General Provider Information

NPI Number	:	1376351726
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECKA SMITH BCBA, LBA

Provider Business Mailing Address
First Line	:	8100 CYPRESSWOOD DR APT 1014
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-7192
Country	:	US
Telephone Number	:	936-355-1968
Fax Number	:

Provider Business Practice Location Address
First Line	:	2045 SPRING STUEBNER RD STE 600
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77389-4812
Country	:	US
Telephone Number	:	817-562-0909
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/18/2024
Last Update Date	:	01/15/2025

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