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General NPI Number Information
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NPI Number | 1710003629
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Entity Type | Individual
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Provider Name | REBECCA HARRELL-BISHIR M.A. CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 12/08/2015
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Provider Practice Location Address
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Address Line | 1332 N RACCOON HILL RD
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City | PERU
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State | IN
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Zip | 46970-7670
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Country | US
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Telephone | 765-460-7645
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Fax |
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Provider Business Mailing Address
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Address Line | 1332 N RACCOON HILL RD
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City | PERU
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State | IN
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Zip | 46970-7670
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Country | US
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Telephone | 765-460-7645
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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 | SA 7434
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License Number State | FL
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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 | 22005872A
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License Number State | IN
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