Provider Demographics
NPI:1215724034
Name:BULUT, REBECCA FRANCES
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:FRANCES
Last Name:BULUT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2426 CONFEDERATE DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-0219
Mailing Address - Country:US
Mailing Address - Phone:980-328-6068
Mailing Address - Fax:
Practice Address - Street 1:6740 ROCK SPRING RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28405-3185
Practice Address - Country:US
Practice Address - Phone:910-390-6626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCRBT-25-425626106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician