Provider Demographics
NPI:1366775991
Name:GIBSON-DYE, REBECCA LYNN (SPEECH LANGUAGE PATH)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:LYNN
Last Name:GIBSON-DYE
Suffix:
Gender:F
Credentials:SPEECH LANGUAGE PATH
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Mailing Address - Street 1:342 VIRGINIA AVENUE
Mailing Address - Street 2:HEARTLAND REHABILITATION SERVICES OF VIRGINIA, INC
Mailing Address - City:WYTHEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24382
Mailing Address - Country:US
Mailing Address - Phone:276-228-6200
Mailing Address - Fax:276-228-9175
Practice Address - Street 1:342 VIRGINIA AVENUE
Practice Address - Street 2:HEARTLAND REHABILITATION SERVICES OF VIRGINIA, INC
Practice Address - City:WYTHEVILLE
Practice Address - State:VA
Practice Address - Zip Code:24382
Practice Address - Country:US
Practice Address - Phone:276-228-6200
Practice Address - Fax:276-228-9175
Is Sole Proprietor?:No
Enumeration Date:2009-09-15
Last Update Date:2009-09-15
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Provider Licenses
StateLicense IDTaxonomies
VA2202003602235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist