Provider Demographics
NPI:1235917998
Name:HORN, REBECCA A (MA - SLP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:A
Last Name:HORN
Suffix:
Gender:F
Credentials:MA - SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WAYMONT CT STE 120
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-3412
Mailing Address - Country:US
Mailing Address - Phone:407-323-0399
Mailing Address - Fax:
Practice Address - Street 1:100 WAYMONT CT STE 120
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3412
Practice Address - Country:US
Practice Address - Phone:407-323-0399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ11520235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist