Provider Demographics
NPI:1023341773
Name:BLANKENHORN, REBECCA (AUD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:
Last Name:BLANKENHORN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610 CENTER ST.
Mailing Address - Street 2:SUITE A
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36604
Mailing Address - Country:US
Mailing Address - Phone:404-616-6550
Mailing Address - Fax:
Practice Address - Street 1:1610 CENTER ST.
Practice Address - Street 2:SUITE A
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36604
Practice Address - Country:US
Practice Address - Phone:251-432-4560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-14
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAUD003828231H00000X
AL1119A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist