Provider Demographics
NPI:1245496587
Name:WINTERS, REBECCA ALLYSON (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ALLYSON
Last Name:WINTERS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 GARDEN OAKS DR
Mailing Address - Street 2:
Mailing Address - City:MAUMELLE
Mailing Address - State:AR
Mailing Address - Zip Code:72113-6861
Mailing Address - Country:US
Mailing Address - Phone:501-951-2125
Mailing Address - Fax:
Practice Address - Street 1:32 GARDEN OAKS DR
Practice Address - Street 2:
Practice Address - City:MAUMELLE
Practice Address - State:AR
Practice Address - Zip Code:72113-6861
Practice Address - Country:US
Practice Address - Phone:501-951-2125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-06
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#2597235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist