Provider Demographics
NPI:1841772399
Name:LEGER, REBECCA M (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:M
Last Name:LEGER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:M
Other - Last Name:DEVERELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:39 LIMERICK RD
Mailing Address - Street 2:
Mailing Address - City:ARUNDEL
Mailing Address - State:ME
Mailing Address - Zip Code:04046-8158
Mailing Address - Country:US
Mailing Address - Phone:207-215-6728
Mailing Address - Fax:207-985-6703
Practice Address - Street 1:39 LIMERICK RD
Practice Address - Street 2:
Practice Address - City:ARUNDEL
Practice Address - State:ME
Practice Address - Zip Code:04046-8158
Practice Address - Country:US
Practice Address - Phone:207-215-6728
Practice Address - Fax:207-985-6703
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-31
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP1265235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty