Provider Demographics
NPI:1154696219
Name:READY, REBECCA B (CCC-SLP)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:B
Last Name:READY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 LEDGEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03839-5619
Mailing Address - Country:US
Mailing Address - Phone:603-502-3376
Mailing Address - Fax:
Practice Address - Street 1:469 MAIN ST
Practice Address - Street 2:SUITE 102
Practice Address - City:SPRINGVALE
Practice Address - State:ME
Practice Address - Zip Code:04083-1870
Practice Address - Country:US
Practice Address - Phone:207-324-2888
Practice Address - Fax:207-324-2879
Is Sole Proprietor?:No
Enumeration Date:2012-03-21
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP719235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist