Individual
DR. REBECCA TAGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD, BCBA-D
Contact information
Practice address
217 STATION ST, JACKSONVILLE, NC 28546-6304
(910) 378-2501
(910) 939-1490
Mailing address
217 STATION ST, JACKSONVILLE, NC 28546-6304
(910) 378-2501
(910) 939-1490
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-11-9642
NC
103T00000X
Psychologist
103213
NC
103TC0700X
Clinical Psychologist
Primary
5321
NC
103TS0200X
School Psychologist
—
NC
Other
Enumeration date
08/09/2011
Last updated
01/24/2023
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