Provider Demographics
NPI:1114681152
Name:WARREN, REBECCA ANN (SPEECH PATHOLOGIST)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANN
Last Name:WARREN
Suffix:
Gender:F
Credentials:SPEECH PATHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3229 WINDING WAY
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-6215
Mailing Address - Country:US
Mailing Address - Phone:512-810-1800
Mailing Address - Fax:
Practice Address - Street 1:306 W SOUTH ST
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-1717
Practice Address - Country:US
Practice Address - Phone:512-570-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19278235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist