Provider Demographics
NPI:1386977627
Name:LOTT, REBECCA M (SLP)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:M
Last Name:LOTT
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 1:6908 HICKORY VIEW LN
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-2533
Mailing Address - Country:US
Mailing Address - Phone:423-598-2366
Mailing Address - Fax:423-499-9356
Practice Address - Street 1:6594 ORANGE PLANK DR
Practice Address - Street 2:
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343-3394
Practice Address - Country:US
Practice Address - Phone:423-598-2366
Practice Address - Fax:423-499-9356
Is Sole Proprietor?:No
Enumeration Date:2009-09-17
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3429235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist