Provider Demographics
NPI:1538498746
Name:MCGONIGLE, REBECCA SCOTT (MSCCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:SCOTT
Last Name:MCGONIGLE
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 COMMONS BLVD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19605-3334
Mailing Address - Country:US
Mailing Address - Phone:610-987-8543
Mailing Address - Fax:
Practice Address - Street 1:1111 COMMONS BLVD
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19605-3334
Practice Address - Country:US
Practice Address - Phone:610-987-8543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-17
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL008508235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist