Individual
REBECCA MACKALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
13900 HULL STREET RD, MIDLOTHIAN, VA 23112-2004
(804) 639-8900
Mailing address
872 FAIRWAY DR, WAYNESBORO, VA 22980-3352
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202006662
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2202006662
BOARD OF SPEECH PATHOLOGY AND AUDIOLIOGY
VA
Enumeration date
10/24/2018
Last updated
09/05/2024
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