Provider Demographics
NPI:1386841310
Name:BELCHER, REBECKA LAURA (SLP)
Entity Type:Individual
Prefix:
First Name:REBECKA
Middle Name:LAURA
Last Name:BELCHER
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 1:307 NORWOOD DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-1255
Mailing Address - Country:US
Mailing Address - Phone:859-608-6143
Mailing Address - Fax:
Practice Address - Street 1:31 DERICKSON LN
Practice Address - Street 2:
Practice Address - City:STANTON
Practice Address - State:KY
Practice Address - Zip Code:40380-2153
Practice Address - Country:US
Practice Address - Phone:606-663-0435
Practice Address - Fax:606-663-8040
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2811235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist