Provider Demographics
NPI:1699146506
Name:GINTER, REBECCA (MA CCC-SLP TSSLD)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:GINTER
Suffix:
Gender:F
Credentials:MA CCC-SLP TSSLD
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:VEDRIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:72 CHAPIN AVE
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-1941
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:23110 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11427-2631
Practice Address - Country:US
Practice Address - Phone:718-464-5606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-19
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025221235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist