MEDICARE: MRS. REBECCA DAWN WALDEN

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

General Provider Information

NPI Number	:	1942541131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. REBECCA DAWN WALDEN

Provider Business Mailing Address
First Line	:	50 HOLLY SPRINGS RD
Second Line	:
City	:	SHARPSBURG
State	:	GA
Zip	:	30277-1968
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	50 HOLLY SPRINGS RD
Second Line	:
City	:	SHARPSBURG
State	:	GA
Zip	:	30277-1968
Country	:	US
Telephone Number	:	678-725-3736
Fax Number	:

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

Provider Enumeration Date	:	03/13/2013
Last Update Date	:	04/12/2026

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