Provider Demographics
NPI:1558478156
Name:IMLER, REBEKAH A (MA, CCC-A)
Entity Type:Individual
Prefix:MRS
First Name:REBEKAH
Middle Name:A
Last Name:IMLER
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:CIRCLEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43113-9056
Mailing Address - Country:US
Mailing Address - Phone:740-474-3818
Mailing Address - Fax:
Practice Address - Street 1:113 ISLAND RD
Practice Address - Street 2:
Practice Address - City:CIRCLEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43113-9056
Practice Address - Country:US
Practice Address - Phone:740-474-3818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA 01007237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter