Provider Demographics
NPI:1285122390
Name:HORSEY, REBECCA (MCD, CCC-SLP)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:HORSEY
Suffix:
Gender:F
Credentials:MCD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1731 BRADLEY DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29204-3156
Mailing Address - Country:US
Mailing Address - Phone:803-260-9798
Mailing Address - Fax:
Practice Address - Street 1:3220 HATCHET BAY DR APT 3203
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-5211
Practice Address - Country:US
Practice Address - Phone:803-260-9798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-24
Last Update Date:2020-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6519235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist