Provider Demographics
NPI:1629538749
Name:REKIK, IBTISSEM (MS, CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:IBTISSEM
Middle Name:
Last Name:REKIK
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MR
Other - First Name:IBBY
Other - Middle Name:
Other - Last Name:REKIK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:7 CARNEGIE PLAZA
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-1000
Mailing Address - Country:US
Mailing Address - Phone:877-407-3422
Mailing Address - Fax:877-407-4329
Practice Address - Street 1:1200 1ST ST NE FL
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-3361
Practice Address - Country:US
Practice Address - Phone:202-442-4366
Practice Address - Fax:202-281-8516
Is Sole Proprietor?:No
Enumeration Date:2019-03-24
Last Update Date:2024-11-05
Deactivation Date:2020-02-25
Deactivation Code:
Reactivation Date:2020-07-30
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
MD10222235Z00000X
DC200001336235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist