Provider Demographics
NPI:1871163550
Name:GEORGE, REBECCA (SLPA)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:GEORGE
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5191
Mailing Address - Street 2:
Mailing Address - City:JBER
Mailing Address - State:AK
Mailing Address - Zip Code:99505-0191
Mailing Address - Country:US
Mailing Address - Phone:970-901-8447
Mailing Address - Fax:
Practice Address - Street 1:12580 OLD SEWARD HWY
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-3506
Practice Address - Country:US
Practice Address - Phone:907-301-4588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-25
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1788752355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant