Provider Demographics
NPI:1477136190
Name:DINWOODIE, REBECKA F
Entity Type:Individual
Prefix:
First Name:REBECKA
Middle Name:F
Last Name:DINWOODIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:484 POND RD
Mailing Address - Street 2:
Mailing Address - City:WALES
Mailing Address - State:ME
Mailing Address - Zip Code:04280-2520
Mailing Address - Country:US
Mailing Address - Phone:860-921-7313
Mailing Address - Fax:
Practice Address - Street 1:639 HATHAWAY ST
Practice Address - Street 2:
Practice Address - City:FAIRPLAY
Practice Address - State:CO
Practice Address - Zip Code:80440
Practice Address - Country:US
Practice Address - Phone:860-921-7313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-30
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSLP.0004352235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist