Provider Demographics
NPI:1518215870
Name:MCGARRY, REBECCA A (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:A
Last Name:MCGARRY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:626 E 600 S
Mailing Address - Street 2:
Mailing Address - City:MANTI
Mailing Address - State:UT
Mailing Address - Zip Code:84642-1747
Mailing Address - Country:US
Mailing Address - Phone:435-851-3317
Mailing Address - Fax:
Practice Address - Street 1:4000 S 700 E STE 10
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107-2580
Practice Address - Country:US
Practice Address - Phone:801-268-8349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-16
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8281398-4104235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist