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Individual

REBECCA R MEDLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS CCC SLP

Contact information

Practice address
982 EASTERN PKWY, LOUISVILLE, KY 40217
(502) 635-6397
(502) 635-1147
Mailing address
2402 SHERRY RD, LOUISVILLE, KY 40217
(502) 638-0595

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2127
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000186059
ANTHEM
Enumeration date
11/03/2006
Last updated
07/08/2007
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