Healthcare Provider Details

I. General information

NPI: 1558698977
Provider Name (Legal Business Name): REBECCA L GARNICK MS/CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2009
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 MEL LAWN DR
FORT THOMAS KY
41075-1034
US

IV. Provider business mailing address

10 MEL LAWN DR
FORT THOMAS KY
41075-1034
US

V. Phone/Fax

Practice location:
  • Phone: 859-757-8648
  • Fax:
Mailing address:
  • Phone: 859-757-8648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number1330
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: