Provider Demographics
NPI:1821577800
Name:OWENS, REBECCA WALSTON (AU D)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:WALSTON
Last Name:OWENS
Suffix:
Gender:F
Credentials:AU D
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:ELISE
Other - Last Name:WALSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:1015 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29646-3831
Mailing Address - Country:US
Mailing Address - Phone:864-227-8612
Mailing Address - Fax:864-229-2082
Practice Address - Street 1:1015 SPRING ST
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29646-3831
Practice Address - Country:US
Practice Address - Phone:864-227-8612
Practice Address - Fax:864-229-2082
Is Sole Proprietor?:No
Enumeration Date:2018-08-09
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist