Provider Demographics
NPI:1851028906
Name:LANGLEY, REBEKAH JO (MCD-CCC/SLP)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:JO
Last Name:LANGLEY
Suffix:
Gender:F
Credentials:MCD-CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16352 LAKEVIEW CIR
Mailing Address - Street 2:
Mailing Address - City:TROUP
Mailing Address - State:TX
Mailing Address - Zip Code:75789-3610
Mailing Address - Country:US
Mailing Address - Phone:903-235-9967
Mailing Address - Fax:
Practice Address - Street 1:415 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ARP
Practice Address - State:TX
Practice Address - Zip Code:75750-4607
Practice Address - Country:US
Practice Address - Phone:903-859-4650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-08
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
24521235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist