Provider Demographics
NPI:1811132988
Name:CONNER, REBECCA K (MA)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:K
Last Name:CONNER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1444 WESTPARK DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-1073
Mailing Address - Country:US
Mailing Address - Phone:252-917-0792
Mailing Address - Fax:
Practice Address - Street 1:1444 WESTPARK DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-1073
Practice Address - Country:US
Practice Address - Phone:252-917-0792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-03
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7862235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist