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NPI Code Detail

MEDICARE: MRS. REBECCA JEAN BISSETT M.S. CCC-SLP

MEDICARE: MRS. REBECCA JEAN BISSETT 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 PathologistSLP 0426WV

General Provider Information

NPI Number : 1992033492
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. REBECCA JEAN BISSETT M.S. CCC-SLP
Provider Business Mailing Address
First Line : 9 RICHLAND DR
Second Line :
City : HURRICANE
State : WV
Zip : 25526-8803
Country : US
Telephone Number : 304-757-5248
Fax Number :
Provider Business Practice Location Address
First Line : 113 LAKEVIEW DR
Second Line :
City : CHARLESTON
State : WV
Zip : 25313-1467
Country : US
Telephone Number : 304-342-9515
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2009
Last Update Date : 11/23/2009

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Directions to “ MRS. REBECCA JEAN BISSETT M.S. CCC-SLP” Practice Location

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