Provider Demographics
NPI:1528585593
Name:STEWART, REBECCA ROYAL (AUD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:ROYAL
Last Name:STEWART
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 1:8035 PROVIDENCE RD STE 320
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-8910
Mailing Address - Country:US
Mailing Address - Phone:704-752-7575
Mailing Address - Fax:
Practice Address - Street 1:1107 REYNOLDS ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28112-4351
Practice Address - Country:US
Practice Address - Phone:704-289-8220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12667231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist