Provider Demographics
NPI:1831810423
Name:BIANCO, REBECCA L (MACCC/SLP-L)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:L
Last Name:BIANCO
Suffix:
Gender:F
Credentials:MACCC/SLP-L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 ASHLEY DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLINVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08322-2686
Mailing Address - Country:US
Mailing Address - Phone:856-305-7959
Mailing Address - Fax:
Practice Address - Street 1:47 ASHLEY DR
Practice Address - Street 2:
Practice Address - City:FRANKLINVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08322-2686
Practice Address - Country:US
Practice Address - Phone:856-305-7959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00528300235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist