Provider Demographics
NPI:1457976904
Name:JONES, REBECCA LEA (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:LEA
Last Name:JONES
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 1:8218 HIGHWAY 79 S
Mailing Address - Street 2:
Mailing Address - City:HENRY
Mailing Address - State:TN
Mailing Address - Zip Code:38231-3966
Mailing Address - Country:US
Mailing Address - Phone:731-336-5031
Mailing Address - Fax:
Practice Address - Street 1:800 VOLUNTEER DR
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TN
Practice Address - Zip Code:38242-5472
Practice Address - Country:US
Practice Address - Phone:731-642-2535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-10
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4158235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist