Provider Demographics
NPI:1558679076
Name:MCKENZIE, REBEKAH J (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:REBEKAH
Middle Name:J
Last Name:MCKENZIE
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 1:6068 IRONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59106-9685
Mailing Address - Country:US
Mailing Address - Phone:406-530-7188
Mailing Address - Fax:844-415-2186
Practice Address - Street 1:6068 IRONWOOD DR
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59106-9685
Practice Address - Country:US
Practice Address - Phone:406-530-7188
Practice Address - Fax:844-415-2186
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-17
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9061235Z00000X
MTSLP-SLP-LIC-7314235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist