Provider Demographics
NPI:1568157410
Name:MCPHERSON, REBEKAH (PHD, CCC-SLP)
Entity Type:Individual
Prefix:DR
First Name:REBEKAH
Middle Name:
Last Name:MCPHERSON
Suffix:
Gender:F
Credentials:PHD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9921 WESTPARK DR
Mailing Address - Street 2:
Mailing Address - City:BENBROOK
Mailing Address - State:TX
Mailing Address - Zip Code:76126-4123
Mailing Address - Country:US
Mailing Address - Phone:817-296-2207
Mailing Address - Fax:
Practice Address - Street 1:9921 WESTPARK DR
Practice Address - Street 2:
Practice Address - City:BENBROOK
Practice Address - State:TX
Practice Address - Zip Code:76126-4123
Practice Address - Country:US
Practice Address - Phone:817-296-2207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118730235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX120085901Medicaid