Provider Demographics
NPI:1730868464
Name:DUFFNER, REBEKAH THOMPSON (MA)
Entity type:Individual
Prefix:
First Name:REBEKAH
Middle Name:THOMPSON
Last Name:DUFFNER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 STEPHENSON AVE STE A
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-4347
Mailing Address - Country:US
Mailing Address - Phone:912-335-3881
Mailing Address - Fax:
Practice Address - Street 1:314 STEPHENSON AVE STE A
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4347
Practice Address - Country:US
Practice Address - Phone:912-335-3881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-11
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
GAAPC009317101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty