Provider Demographics
NPI:1356541528
Name:MORONE, REBECCA S (MA CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:S
Last Name:MORONE
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3825 COVE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47203-3605
Mailing Address - Country:US
Mailing Address - Phone:812-376-6329
Mailing Address - Fax:
Practice Address - Street 1:3825 COVE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47203-3605
Practice Address - Country:US
Practice Address - Phone:812-376-6329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22001148A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist