Provider Demographics
NPI:1114777380
Name:COWAN, REBECCA ANN (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANN
Last Name:COWAN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1199 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEPHI
Mailing Address - State:UT
Mailing Address - Zip Code:84648-2504
Mailing Address - Country:US
Mailing Address - Phone:435-623-0328
Mailing Address - Fax:435-623-4212
Practice Address - Street 1:1199 S MAIN ST
Practice Address - Street 2:
Practice Address - City:NEPHI
Practice Address - State:UT
Practice Address - Zip Code:84648-2504
Practice Address - Country:US
Practice Address - Phone:435-623-0328
Practice Address - Fax:435-623-4212
Is Sole Proprietor?:No
Enumeration Date:2024-03-22
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13950891-4102235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist