Provider Demographics
NPI:1295086460
Name:OAKLEY, REBEKAH MINA (PHD, LP)
Entity type:Individual
Prefix:MRS
First Name:REBEKAH
Middle Name:MINA
Last Name:OAKLEY
Suffix:
Gender:F
Credentials:PHD, LP
Other - Prefix:MRS
Other - First Name:REBEKAH
Other - Middle Name:MINA
Other - Last Name:HAYNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:3010 SCOTT BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76504-6803
Mailing Address - Country:US
Mailing Address - Phone:844-824-8775
Mailing Address - Fax:
Practice Address - Street 1:3010 SCOTT BLVD STE 103
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504-6803
Practice Address - Country:US
Practice Address - Phone:844-824-8775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-27
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36165103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist