Provider Demographics
NPI:1164085338
Name:BRANSTETTER, REBECCA D (LPC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:D
Last Name:BRANSTETTER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1219 E MINTON DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-7132
Mailing Address - Country:US
Mailing Address - Phone:928-595-0270
Mailing Address - Fax:
Practice Address - Street 1:1219 E MINTON DR
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7132
Practice Address - Country:US
Practice Address - Phone:928-595-0270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-15
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-17967101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional