Provider Demographics
NPI:1952128480
Name:MCKINLEY, REBECCA CARLI (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:CARLI
Last Name:MCKINLEY
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 1:913 COLISEUM BLVD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36109-1209
Mailing Address - Country:US
Mailing Address - Phone:334-233-7430
Mailing Address - Fax:
Practice Address - Street 1:4209 CARMICHAEL RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-3601
Practice Address - Country:US
Practice Address - Phone:334-356-1020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist