Provider Demographics
NPI:1235945437
Name:BUTLER, REBECCA B
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:B
Last Name:BUTLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14126 ROSETTA DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-2558
Mailing Address - Country:US
Mailing Address - Phone:346-634-3499
Mailing Address - Fax:
Practice Address - Street 1:16410 CYPRESS ROSEHILL RD
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-1428
Practice Address - Country:US
Practice Address - Phone:832-406-4441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-04
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty