Provider Demographics
NPI:1689933822
Name:MARKS, REBECCA J (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:J
Last Name:MARKS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 CROWN PT
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27332-6638
Mailing Address - Country:US
Mailing Address - Phone:336-446-9237
Mailing Address - Fax:877-540-0370
Practice Address - Street 1:345 CROWN PT
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27332-6638
Practice Address - Country:US
Practice Address - Phone:765-661-6501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-09
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8593235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist