Provider Demographics
NPI:1386398188
Name:JONES, REBECCA MARIA (SLP)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:MARIA
Last Name:JONES
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4257 S 1650 E
Mailing Address - Street 2:
Mailing Address - City:HOLLADAY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-2555
Mailing Address - Country:US
Mailing Address - Phone:801-721-8442
Mailing Address - Fax:
Practice Address - Street 1:240 MORRIS AVE STE 400
Practice Address - Street 2:
Practice Address - City:SOUTH SALT LAKE
Practice Address - State:UT
Practice Address - Zip Code:84115-3295
Practice Address - Country:US
Practice Address - Phone:801-801-5815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-10
Last Update Date:2022-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7456873-4102235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist