Provider Demographics
NPI:1184430712
Name:FLANCRAICH, REBECCA (MS CCC-SLP TSSLD)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:FLANCRAICH
Suffix:
Gender:F
Credentials:MS CCC-SLP TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:357 15TH ST APT 1A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-5980
Mailing Address - Country:US
Mailing Address - Phone:917-468-4059
Mailing Address - Fax:
Practice Address - Street 1:18 BEAVER ST FL 3
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-4504
Practice Address - Country:US
Practice Address - Phone:718-388-9494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035074235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist