MEDICARE: MISS REBECCA LEE SINCLAIR M.A. CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	6922	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	6922	OTHER	NC	NC LICENSE #
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588625453
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS REBECCA LEE SINCLAIR M.A. CCC-SLP

Provider Business Mailing Address
First Line	:	14625 LEBANON RD
Second Line	:	SUITE G
City	:	OLD HICKORY
State	:	TN
Zip	:	37138-4620
Country	:	US
Telephone Number	:	615-758-4888
Fax Number	:	615-758-6188

Provider Business Practice Location Address
First Line	:	1127 MCCHESNEY AVE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37216-2726
Country	:	US
Telephone Number	:	865-384-2836
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2006
Last Update Date	:	12/10/2008

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