MEDICARE: DR. REBECCA DAWSON CUBBERLY PH.D.

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	101YP2500X	Professional Counselor	8766	TX
2	106H00000X	Marriage & Family Therapist	000541	TX

General Provider Information

NPI Number	:	1922284330
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REBECCA DAWSON CUBBERLY PH.D.

Provider Business Mailing Address
First Line	:	3024 CHEVY CHASE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77019-3206
Country	:	US
Telephone Number	:	713-528-4020
Fax Number	:

Provider Business Practice Location Address
First Line	:	1720 SUNSET BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77005-1714
Country	:	US
Telephone Number	:	713-528-4020
Fax Number	:

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

Provider Enumeration Date	:	01/15/2008
Last Update Date	:	01/15/2008

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