Provider Demographics
NPI:1982216453
Name:CRAFT, REBECCA G (AUD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:G
Last Name:CRAFT
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 GEORGE WALLACE DRIVE
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35903-2270
Mailing Address - Country:US
Mailing Address - Phone:256-547-8653
Mailing Address - Fax:
Practice Address - Street 1:1100 GEORGE WALLACE DRIVE
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35903-2270
Practice Address - Country:US
Practice Address - Phone:256-547-8653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-17
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1250A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist