1104882448 NPI number — MRS. REBECCA ANN WALKER M.A., CCC-A

Table of content: MRS. REBECCA ANN WALKER M.A., CCC-A (NPI 1104882448)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104882448 NPI number — MRS. REBECCA ANN WALKER M.A., CCC-A

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WALKER
Provider First Name:
REBECCA
Provider Middle Name:
ANN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.A., CCC-A
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BENEDICT
Provider Other First Name:
REBECCA
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.A., CCC-A
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1104882448
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/27/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3893 E MARKET ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WARREN
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44484-4706
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-856-4000
Provider Business Mailing Address Fax Number:
330-609-9910

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3893 E MARKET ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WARREN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44484-4706
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-856-4000
Provider Business Practice Location Address Fax Number:
330-609-9910
Provider Enumeration Date:
04/25/2006

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: 231H00000X , with the licence number:  A.01595 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com