Doctor Name: | MRS. REBECCA JORDAN HAZELWOOD |
NPI Number: | 1245633775 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.ED., CCC-SLP, BCSS |
License Number: | 5065 |
Business Practice Address: | 109 Bee St Ralph H. Johnson Va Medical Center Charleston, SC - 294015703 |
Business Phone Number: | 8437896653 |
Business Fax Number: | |
Mailing Address: | 151b Rutledge Ave, Msc 962 CHARLESTON |
State: | SC |
Postal Code: | 294258903 |
Phone Number: | 8437927162 |
Fax Number: | |
NPI Enumeration Date: | 09/29/2014 |
NPI Last Update Date: | 09/29/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 5065 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |