Provider Demographics
NPI:1427725506
Name:MCCANTS, REBECCA (SLP)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:MCCANTS
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 1:272 CARRINGTON DR
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30605-7063
Mailing Address - Country:US
Mailing Address - Phone:706-714-7917
Mailing Address - Fax:
Practice Address - Street 1:272 CARRINGTON DR
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30605-7063
Practice Address - Country:US
Practice Address - Phone:706-714-7917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-25
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPCET003446235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAPCET003446OtherSTATE LICENSE