Provider Demographics
NPI:1003799412
Name:JACOBS-LOPEZ, REBECCA SUE (RBT)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:SUE
Last Name:JACOBS-LOPEZ
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5945 CLIFFDALE RD STE 1108
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-0034
Mailing Address - Country:US
Mailing Address - Phone:910-587-9384
Mailing Address - Fax:910-500-5336
Practice Address - Street 1:5945 CLIFFDALE RD STE 1108
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-0034
Practice Address - Country:US
Practice Address - Phone:910-587-9384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-31
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician