Provider Demographics
NPI:1518008234
Name:GREGORY, REBECCA S (AUD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:S
Last Name:GREGORY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1803 W NATAL AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-7458
Mailing Address - Country:US
Mailing Address - Phone:480-491-4906
Mailing Address - Fax:
Practice Address - Street 1:1025 N COUNTRY CLUB DR
Practice Address - Street 2:MESA PUBLIC SCHOOLS AUDIOLOGY DEPT.
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85201-3307
Practice Address - Country:US
Practice Address - Phone:480-472-0506
Practice Address - Fax:480-472-0587
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA1797231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist