Provider Demographics
NPI:1619587870
Name:GROSSMAN, REBECCA HOPE (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:HOPE
Last Name:GROSSMAN
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 BUNN DR STE A
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-2859
Mailing Address - Country:US
Mailing Address - Phone:609-430-9200
Mailing Address - Fax:609-430-9202
Practice Address - Street 1:256 BUNN DR STE A
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-2859
Practice Address - Country:US
Practice Address - Phone:609-430-9200
Practice Address - Fax:609-430-9202
Is Sole Proprietor?:No
Enumeration Date:2020-08-03
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL016108235Z00000X
NJ41YS01115000235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist