Doctor Name: | MS. REBECCA LEIGH WISE |
NPI Number: | 1700210887 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., CCC-SLP |
License Number: | 4766 |
Business Practice Address: | 4477 9th Ave Ne Rio Rancho, NM - 871245634 |
Business Phone Number: | 5058927735 |
Business Fax Number: | |
Mailing Address: | 8212 Wolverine Dr Nw, ALBUQUERQUE |
State: | NM |
Postal Code: | 871205268 |
Phone Number: | 5054506932 |
Fax Number: | |
NPI Enumeration Date: | 08/26/2013 |
NPI Last Update Date: | 08/26/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 4766 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
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 |