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General NPI Number Information
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NPI Number | 1659747830
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Entity Type | Individual
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Provider Name | REBECCA LABOMBARD
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Gender | Female
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Dates
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Enumeration Date | 08/11/2015
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Last Update Date | 03/29/2019
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Provider Practice Location Address
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Address Line | 11405 N GREER RANCH PKWY
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City | SURPRISE
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State | AZ
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Zip | 85379-4828
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Country | US
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Telephone | 623-523-8550
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Fax |
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Provider Business Mailing Address
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Address Line | 17600 N 79TH AVE APT 721
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City | GLENDALE
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State | AZ
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Zip | 85308-8682
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Country | US
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Telephone |
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SLP9337
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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 | 028204
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License Number State | NY
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