Provider Demographics
NPI:1558178301
Name:WANEE, REBECCA CAGLE (C-IAYT, MS)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:CAGLE
Last Name:WANEE
Suffix:
Gender:F
Credentials:C-IAYT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:63043 HIGHWAY 25 N
Mailing Address - Street 2:
Mailing Address - City:AMORY
Mailing Address - State:MS
Mailing Address - Zip Code:38821-8008
Mailing Address - Country:US
Mailing Address - Phone:662-646-1282
Mailing Address - Fax:
Practice Address - Street 1:63043 HIGHWAY 25 N
Practice Address - Street 2:
Practice Address - City:AMORY
Practice Address - State:MS
Practice Address - Zip Code:38821-8008
Practice Address - Country:US
Practice Address - Phone:662-646-1282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-16
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist