Provider Demographics
NPI:1356100267
Name:GALLUTIA, REBEKAH J (SLP)
Entity type:Individual
Prefix:
First Name:REBEKAH
Middle Name:J
Last Name:GALLUTIA
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 1:1654 CUMMINS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:SALVISA
Mailing Address - State:KY
Mailing Address - Zip Code:40372-9309
Mailing Address - Country:US
Mailing Address - Phone:859-553-3150
Mailing Address - Fax:
Practice Address - Street 1:1654 CUMMINS FERRY RD
Practice Address - Street 2:
Practice Address - City:SALVISA
Practice Address - State:KY
Practice Address - Zip Code:40372-9309
Practice Address - Country:US
Practice Address - Phone:859-553-3150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-14
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY287788235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist