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NPI 1104304229

NPI 1104304229 : REBECCA L GARCIA SLP : SURPRISE, AZ

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General NPI Number Information
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    NPI Number           |    1104304229
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    Entity Type          |    Individual 
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    Provider Name        |    REBECCA L GARCIA SLP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/31/2018
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    Last Update Date     |    11/04/2024
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Provider Practice Location Address
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    Address Line         |    16772 W BELL RD STE 110 
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    City                 |    SURPRISE
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    State                |    AZ
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    Zip                  |    85374-9702
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    Country              |    US
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    Telephone            |    602-463-0009
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    16233 W ACAPULCO CIR 
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    City                 |    SURPRISE
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    State                |    AZ
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    Zip                  |    85379-5011
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    Country              |    US
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    Telephone            |    602-463-0009
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    2355S0801X
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    Taxonomy Name        |    Speech-Language Assistant
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    License Number       |    SLPA12377
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    License Number State |    AZ
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Taxonomy #2
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    Taxonomy Code        |    235Z00000X
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    Taxonomy Name        |    Speech-Language Pathologist
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    License Number       |    SLP15716
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    License Number State |    AZ
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