Provider Demographics
NPI:1689096554
Name:VORTKAMP, REBECCA (MA, SLP)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:
Last Name:VORTKAMP
Suffix:
Gender:F
Credentials:MA, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 CLERMONT CENTER DR
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:OH
Mailing Address - Zip Code:45103-1990
Mailing Address - Country:US
Mailing Address - Phone:513-735-8300
Mailing Address - Fax:513-735-8371
Practice Address - Street 1:215 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:OH
Practice Address - Zip Code:45103-2803
Practice Address - Country:US
Practice Address - Phone:513-732-0780
Practice Address - Fax:513-732-1863
Is Sole Proprietor?:No
Enumeration Date:2014-01-13
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2014030235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist