Healthcare Provider Details

I. General information

NPI: 1497660476
Provider Name (Legal Business Name): MRS. REBECCA ANNE BARNER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2026
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 N DOUGLAS AVE
WINSLOW AZ
86047-3257
US

IV. Provider business mailing address

701 N DOUGLAS AVE
WINSLOW AZ
86047-3257
US

V. Phone/Fax

Practice location:
  • Phone: 724-989-7714
  • Fax:
Mailing address:
  • Phone: 724-989-7714
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSLPA12467
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: