1164552675 NPI number — MS. REBECCA L VANLIER SLP

Table of content: MS. REBECCA L VANLIER SLP (NPI 1164552675)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164552675 NPI number — MS. REBECCA L VANLIER SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VANLIER
Provider First Name:
REBECCA
Provider Middle Name:
L
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164552675
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
910 QUAIL RIDGE CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EARLYSVILLE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22936-9593
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
434-975-3512
Provider Business Mailing Address Fax Number:
434-979-8536

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1102 ROSE HILL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHARLOTTESVILLE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22903-5128
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
434-979-8628
Provider Business Practice Location Address Fax Number:
434-979-8536
Provider Enumeration Date:
03/06/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  2202001213 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7969057 . This is a "AETNA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 225543 . This is a "SOUTHERN HEALTH" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".