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NPI Code Detail

MEDICARE: REBECCA RAE FLEEGER M.S. CCC-SLP

MEDICARE: REBECCA RAE FLEEGER M.S. CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist109573TX

General Provider Information

NPI Number : 1114313855
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA RAE FLEEGER M.S. CCC-SLP
Provider Business Mailing Address
First Line : 1684 NIAGARA BLVD
Second Line :
City : LEWISVILLE
State : TX
Zip : 75077-2450
Country : US
Telephone Number : 972-965-9816
Fax Number :
Provider Business Practice Location Address
First Line : 190 CIVIC CIR STE 250
Second Line :
City : LEWISVILLE
State : TX
Zip : 75067-3648
Country : US
Telephone Number : 972-219-1200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2015
Last Update Date : 04/09/2015

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Directions to “ REBECCA RAE FLEEGER M.S. CCC-SLP” Practice Location

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