Provider Demographics
NPI:1669687828
Name:HANSON, REBECCA A (SLP)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:A
Last Name:HANSON
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 OLD MILL RD
Mailing Address - Street 2:
Mailing Address - City:GETTYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17325-8425
Mailing Address - Country:US
Mailing Address - Phone:717-357-6183
Mailing Address - Fax:
Practice Address - Street 1:165 OLD MILL RD
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-8425
Practice Address - Country:US
Practice Address - Phone:717-357-6183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL012318235Z00000X
MD07748235Z00000X
NM5126235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist