Provider Demographics
NPI:1326329400
Name:GATES, REBECCA H (SLP)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:H
Last Name:GATES
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 720
Mailing Address - Street 2:
Mailing Address - City:REEDS SPRING
Mailing Address - State:MO
Mailing Address - Zip Code:65737-0720
Mailing Address - Country:US
Mailing Address - Phone:417-699-1820
Mailing Address - Fax:417-272-0269
Practice Address - Street 1:678 SPLITRAIL PASS
Practice Address - Street 2:
Practice Address - City:BRANSON WEST
Practice Address - State:MO
Practice Address - Zip Code:65737-8441
Practice Address - Country:US
Practice Address - Phone:417-699-1820
Practice Address - Fax:417-272-0269
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-02
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist