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General NPI Number Information
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NPI Number | 1417550039
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Entity Type | Individual
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Provider Name | REBECCA HABER M.S.ED, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 11/17/2020
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Last Update Date | 01/18/2022
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Provider Practice Location Address
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Address Line | 4997 ROYAL GULF CIR
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City | FORT MYERS
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State | FL
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Zip | 33966-7006
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Country | US
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Telephone | 239-313-5049
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Fax |
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Provider Business Mailing Address
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Address Line | 19851 BRECKENRIDGE DR UNIT 202
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City | ESTERO
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State | FL
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Zip | 33928-4147
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Country | US
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Telephone | 631-745-6715
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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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 | SZ10006
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License Number State | FL
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