Provider Demographics
NPI:1457143968
Name:ADAMS, REBECCA JANE (MA SLP)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:JANE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MA SLP
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:JANE
Other - Last Name:KRUG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:103 E MANSION ST
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MI
Mailing Address - Zip Code:49068-1117
Mailing Address - Country:US
Mailing Address - Phone:269-789-8990
Mailing Address - Fax:
Practice Address - Street 1:103 E MANSION ST
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MI
Practice Address - Zip Code:49068-1117
Practice Address - Country:US
Practice Address - Phone:269-789-8990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7152001122235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist