Provider Demographics
NPI:1932874989
Name:DAGHER, REBEKKA TERE (MS CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:REBEKKA
Middle Name:TERE
Last Name:DAGHER
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 BILLOU ST
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-5116
Mailing Address - Country:US
Mailing Address - Phone:415-446-8100
Mailing Address - Fax:
Practice Address - Street 1:1826 BUTTE ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94804-5218
Practice Address - Country:US
Practice Address - Phone:415-446-8100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-11
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29379235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist