Provider Demographics
NPI:1497976088
Name:RODE, REBEKAH A S (MED, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:REBEKAH
Middle Name:A S
Last Name:RODE
Suffix:
Gender:F
Credentials:MED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 HIGH STREET
Mailing Address - Street 2:APARTMENT C
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23704
Mailing Address - Country:US
Mailing Address - Phone:703-652-9478
Mailing Address - Fax:
Practice Address - Street 1:5835 HARBOUR VIEW BLVD.
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435
Practice Address - Country:US
Practice Address - Phone:757-668-6037
Practice Address - Fax:757-668-6025
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202005114235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist