Provider Demographics
NPI:1801225107
Name:HOUTSMA, REBECCA AUKJE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:AUKJE
Last Name:HOUTSMA
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Gender:F
Credentials:MS, CCC-SLP
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Mailing Address - Street 1:ECKELMANN TAYLOR SPEECH AND HEARING CLINIC
Mailing Address - Street 2:CAMPUS BOX 4720
Mailing Address - City:NORMAL
Mailing Address - State:IL
Mailing Address - Zip Code:61790-4720
Mailing Address - Country:US
Mailing Address - Phone:309-438-8641
Mailing Address - Fax:309-438-5221
Practice Address - Street 1:275 ILLINOIS STATE UNIV
Practice Address - Street 2:211 RACHEL COOPER BUILDING
Practice Address - City:NORMAL
Practice Address - State:IL
Practice Address - Zip Code:61790-0001
Practice Address - Country:US
Practice Address - Phone:309-438-8641
Practice Address - Fax:309-438-5221
Is Sole Proprietor?:No
Enumeration Date:2013-11-06
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
146-008127235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist