Provider Demographics
NPI:1184955056
Name:DENDAUW, REBECCA EILEEN (SLP)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:EILEEN
Last Name:DENDAUW
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4030 SANTA FE DR
Mailing Address - Street 2:
Mailing Address - City:FALLON
Mailing Address - State:NV
Mailing Address - Zip Code:89406-5246
Mailing Address - Country:US
Mailing Address - Phone:775-217-0504
Mailing Address - Fax:
Practice Address - Street 1:1099 MERTON DR
Practice Address - Street 2:
Practice Address - City:FALLON
Practice Address - State:NV
Practice Address - Zip Code:89406-3676
Practice Address - Country:US
Practice Address - Phone:775-423-1999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-16
Last Update Date:2010-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSP-638235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist