Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist |
NPI | 1629315734 |
---|---|
Provider Name | Dr. Rebecca Leigh Bevans |
First Address | Carson City, NV 89701-5262 |
Second Address | Carson City, NV 89701-5262 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2013 |
Last Update Date | 09/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
103TR0400X | (05) | NV |