Provider Demographics
NPI:1144598335
Name:BENEFIELD, REBECCA IRELAND (MED, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:IRELAND
Last Name:BENEFIELD
Suffix:
Gender:F
Credentials:MED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1181 VICKERY LN
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-0632
Mailing Address - Country:US
Mailing Address - Phone:901-729-7773
Mailing Address - Fax:901-729-7774
Practice Address - Street 1:1181 VICKERY LN
Practice Address - Street 2:SUITE 102
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-0632
Practice Address - Country:US
Practice Address - Phone:901-729-7773
Practice Address - Fax:901-729-7774
Is Sole Proprietor?:No
Enumeration Date:2011-12-02
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3351235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist