Provider Demographics
NPI:1356674865
Name:ALVERSON, REBECCA KATE (MA)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:KATE
Last Name:ALVERSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 RBC DR
Mailing Address - Street 2:
Mailing Address - City:RINGGOLD
Mailing Address - State:GA
Mailing Address - Zip Code:30736-2788
Mailing Address - Country:US
Mailing Address - Phone:706-937-3277
Mailing Address - Fax:706-952-1181
Practice Address - Street 1:109 RBC DR
Practice Address - Street 2:
Practice Address - City:RINGGOLD
Practice Address - State:GA
Practice Address - Zip Code:30736-2788
Practice Address - Country:US
Practice Address - Phone:706-937-3277
Practice Address - Fax:706-952-1181
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-15
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAUD003756231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003110156DMedicaid
GA753091OtherWELLCARE
GA01677279OtherAMERIGROUP
GA003110156BMedicaid