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NPI Code Detail

MEDICARE: REBECCA HUCKS FLAGG

MEDICARE: REBECCA HUCKS FLAGG
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1437842598
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA HUCKS FLAGG
Provider Business Mailing Address
First Line : 1198 MUNRO AVE
Second Line :
City : COLUMBUS
State : GA
Zip : 31906-2410
Country : US
Telephone Number : 706-587-5484
Fax Number :
Provider Business Practice Location Address
First Line : 4917 GOLDEN TRIANGLE BLVD STE 411
Second Line :
City : FORT WORTH
State : TX
Zip : 76244-4672
Country : US
Telephone Number : 817-734-6515
Fax Number : 817-717-8584
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2023
Last Update Date : 06/02/2023

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Directions to “ REBECCA HUCKS FLAGG ” Practice Location

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