Provider Demographics
NPI:1427360205
Name:MEYN, REBECCA K (SLP-CCC)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:K
Last Name:MEYN
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:MISS
Other - First Name:REBECCA
Other - Middle Name:K
Other - Last Name:VOLKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP-CCC
Mailing Address - Street 1:162 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-4207
Mailing Address - Country:US
Mailing Address - Phone:917-838-7563
Mailing Address - Fax:
Practice Address - Street 1:4203 NEW UTRECHT AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219
Practice Address - Country:US
Practice Address - Phone:718-686-9600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-08
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018195-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist