Provider Demographics
NPI:1437751260
Name:FINKENAUR, REBECCA FLINT (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:FLINT
Last Name:FINKENAUR
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-4423
Mailing Address - Country:US
Mailing Address - Phone:610-724-5413
Mailing Address - Fax:
Practice Address - Street 1:912 MAIN ST
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-4423
Practice Address - Country:US
Practice Address - Phone:610-724-5413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS01020900235Z00000X
NY29368235Z00000X
DEO1-0001801235Z00000X
PASL014786235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist