MEDICARE: REBECCA HORSEY MCD, 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
1	235Z00000X	Speech-Language Pathologist	6519	SC

General Provider Information

NPI Number	:	1285122390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA HORSEY MCD, CCC-SLP

Provider Business Mailing Address
First Line	:	1731 BRADLEY DR
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29204-3156
Country	:	US
Telephone Number	:	803-260-9798
Fax Number	:

Provider Business Practice Location Address
First Line	:	3220 HATCHET BAY DR APT 3203
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29414-5211
Country	:	US
Telephone Number	:	803-260-9798
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2018
Last Update Date	:	08/08/2020

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