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NPI Code Detail

MEDICARE: MISS REBECCA LYNN WINSTEAD MCD-CCC,SLP

MEDICARE: MISS REBECCA LYNN WINSTEAD 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
1235Z00000XSpeech-Language Pathologist3604SC

General Provider Information

NPI Number : 1679717284
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS REBECCA LYNN WINSTEAD MCD-CCC,SLP
Provider Business Mailing Address
First Line : 2251 PREOT ST
Second Line :
City : SUMTER
State : SC
Zip : 29150-5915
Country : US
Telephone Number : 803-775-8172
Fax Number :
Provider Business Practice Location Address
First Line : 2825 CARTER RD
Second Line :
City : SUMTER
State : SC
Zip : 29150-1712
Country : US
Telephone Number : 806-469-4032
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2009
Last Update Date : 04/27/2009

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